Kathy'S Kiddieland

10A NCAC 09 .0701 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0713 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.1103 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/8/2026 Number Present: 25 Completed Date: 7/8/2028 Age: From 2 To 9 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant, and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, was available to assist with questions during the visit. Ms. Tolar left for an appointment at 12:30p. Ginger Ferguson, Lead Teacher assisted with the remainder of the visit. A legal designee was left on-site and requested to be completed for Ms. Ferguson to be able to sign off on visit summaries. Ms. Tolar returned at 1:00p to complete the visit summary review. The program’s annual compliance visit was conducted on 1/20/2026. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-six percent (96%) as of 7/7/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center LLC, is current/active as of 7/7/2026. Permit type – Three (3) Star Rated License, issued 9/23/2025 Special Services/Restrictions – first shift, enhanced space. The last fire drill was practiced on 6/18/2026. The last shelter-in-place drill was practiced on 5/8/2026. The last playground inspection was documented on 7/6/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 2/6/2026 with thirteen (13) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Experience. The program does not provide transportation. Space #1, the group of two- to nine-year-olds were engaged free play with legos, cars, cash register, pretend phone, and books. After free play, the group cleaned up to prepare for lunch. Space #2, the group of three- to six-year-olds were engaged in free play with magnetic tiles, dramatic play, soft animals, and books. After free play, the children cleaned up and transitioned to the table for lunch. While seated at the table staff were attempting to place cots for nap. I discussed with one staff member that one of the two should be engaged with the children in reading a story or doing the music movements with the children while the other put cots out. One (1) staff member began doing going on a Bear Hunt movements with the children. While monitoring the classroom, I observed one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Space #3, the group of two- to four-year-old children were engaged in were engaged with bristle block play. While monitoring the classroom, I observed no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Lunch consisted of hotdog, bread, green beans, oranges, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. Staff member KT on-going training hours were not completed for fiscal year 2025-2026. Six (6) hours were needed by 6/1/2026. When asked the staff member stated that she had completed some trainings on outdoor play. We found two (2) certificates, but six (6) on-going hours are still needed for fiscal year 2025-2026. Staff member JL on-going training hours were not completed for fiscal year 2025-2026. Two (2) hours were received, and eight (8) hours are still needed for fiscal year 2025-2026. Staff member GF on-going training hours were not completed for fiscal year 2025-2026. Ten (10) hours of on-going training is needed for fiscal year 2025-2026. Emergency Information and Health Questionnaire was dated 4/17/2025 and was not updated annually. The staff member updated the forms during the visit. Staff member KL Emergency Information and Health Questionnaire were dated 6/12/2025 and was not updated annually. Staff member left in June 2025 and returned to work 12/29/2025, at this time, the staff member was treated as a full-time employee, and all required items were due. Staff members’ first two weeks of orientation topics were completed late based on the full time hire date of 12/29/2025, first two weeks topics were due by 1/12/2026. The documentation of orientation documented the first two weeks training topics were completed on 1/22/2026. We discussed when a staff members employment status changes to full time, to document the date when the status changed and pre-schedule dates to complete the required trainings. Then share the dates with the staff member so that they can assist with reminding you when the trainings are due by. Staff member MM Emergency Information and Health Questionnaire were dated 6/10/2025 and was not updated annually. We discussed as staff complete training to ensure that the staff turn the completed certificates in and put them in their file for review. Also, we reviewed to schedule a day for all staff to review and update their emergency information and health questionnaire to assist with ensuring these are updated annually. Outdoors, I observed on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Also, while monitoring outdoors, I observed trash and debris on both playgrounds. We discussed prior to the children using the playground space, staff will need to conduct a check and remove any broken toys and debris around the playground. Staff stated that the children did not go outside this morning as it was too wet from the heavy rain yesterday evening. Staff have altered their schedule for the children to go outside this afternoon. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space 3, no activity plan posted in the classroom for the current week. GS 110-91(12); .0508(a) 721 All equipment and furnishings were not in good repair. Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. G.S. 110-91(6); .0601(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .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. Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff members had not complete the required number of hours according to their education and experience. .1103(a) 9995 A violation was found for which there is no item number. Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. Technical assistance was provided as follows: Item 428- Space 3, no activity plan posted in the classroom for the current week. When asked the staff member stated that she had taken the activity plan home to work on it and forgot to bring it back in with her this morning. She will bring it with her tomorrow to post. Rule reference: G.S. 110-91(12); Item 721- Outdoors on the small playground, one (1) broken toy in the back left corner of the playground. On the big playground, one (1) trike was beginning to show signs of wear on the metal handles where rust was beginning to show. Rule Reference G.S. 110-91(6); .0601(b) Item 1034- Three (3) staff members Health Questionnaire were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the health questionnaire during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1035- Three (3) staff members Emergency Information were dated 6/10/2025, 6/12/2025, and 4/17/2025 and was not updated annually. Staff updated the emergency information during the visit. Rule Reference: 10A NCAC 09 .0701(a) Item 1052- Three (3) staff members had not complete the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09.1103(a) Item 9995- Space 2, one (1) personal bag in floor under the desk with a staff pocketbook inside. The staff member removed the pocketbook and relocated it to the kitchen area during the visit. Rule Reference: 15A NCAC 18A .2820(f) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/22/26. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 discuss that waiting is difficult to do for many children. Too long of a wait can lead to challenging behaviors. A “what if,” “wait bag,” or “fidget bin” filled with favorite items can be utilized when faced with unpredictable, unstructured time. Planning ahead of time for situations in which waiting occurs can greatly reduce unwanted behaviors. Staff engagement with children is needed to ensure the song with motions is implemented and children participate. Storytime with enthusiasm to keep children interested. I recommended to reach out to Buncombe County Partnership for Children to provide training to assist with classroom management and activities for wait times. -We reviewed sanitation rule 15A NCAC 18A .2831 (i) regarding grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained in a manner which does not encourage the harborage of vermin. The outdoor play space grass was about knee high. When asked about the grass the staff stated that each time the lawn care team came to cut grass, it was raining or had rained and the team was unable to cut the grass. The administrator stated the lawn care team came yesterday to cut the grass and it was pouring rain and the team was unable to cut the grass. We discussed that the lawn care team could come during nap time to cut the grass to assist with missing the afternoon showers. -We reviewed grouping of children. Children should be children of the same age example grouping is two-three year olds, four-five year olds, and school-agers. However, I do understand each child's developmental needs are different. If the children need to be placed with one age below or above their age due to developmental needs, a doctors note will need to be on file. We did review the following rules 10A NCAC 09 .0713(1) when combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group; (2) children of all ages may be cared for together in groups for the first and last operating hour of the day, provided the staff/child ratio for the youngest child in the group is maintained; (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; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0302 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0514 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0802 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.1101 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 1/20/2026 Number Present: 23 Completed Date: 1/20/2026 Age: From 2 To 6 Total Minutes: 290 Time In: 09:55 AM Time Out: 02:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. A signed copy of the visit summary was left on-site with to you. Kathy Tolar, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-five percent (95%) as of 1/5/2026. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care Center, LLC, is current/active as of 1/5/2026. Permit type – Three (3) Star Center License, issued 9/23/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space. The last annual compliance visit was conducted on 2/5/2025. The last fire drill was practiced on 1/8/2026. The last shelter-in-place drill was practiced on10/17/2025. The next emergency drill is due by 1/31/2026. The last playground inspection was documented on 1/2/2026. The last fire inspection was approved on 7/18/2025. The last sanitation inspection was conducted on 8/7/2025 with fourteen (14) demerits for a superior classification. Lead water testing was completed on 1/31/2025. Asbestos testing was completed on 11/13/2024. The Emergency Medical Care plan was posted and current. Emergency Preparedness and Response plan was last updated on 1/24/2025. We discussed the annual review is due on or before 1/24/2026. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. Space #1, the group of two- to six-year-olds were engaged free play with blocks, cars, legos. After free play, the group prepared for lunch. When lunch concluded, the children went to their cots. Space #2, the group of three- to six-year-olds were engaged in free play with dolls, blocks, dramatic play, and cars. Space #3, the group of two- to three-year-old children were engaged in free play with dolls, plastic sea animals, dolls, and pretend food. After free play, the group prepared for lunch. Lunch today consisted of turkey, bread, peaches, mixed vegetables, and milk. One (1) child brings their meals from home and the facility supplements any components that is missing. During nap time, the children were able to engage in quiet activities. The staff played calming music and used natural lighting to help the children rest. The outdoor areas were monitored and incompliance. The administrator stated that the quote for the new playground renovations should be finalized by the end of this week. Staff and children’s files were monitored during the visit. One (1) uncompensated provider hired 6/23/2025 file was missing the following: six (6) clock hours of orientation within the first two (2) weeks of employment, medical report, shaken baby and abusive head trauma policy review prior to caring for children. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. Staff member annual staff evaluations on file were not completed annually. The last completed annual staff evaluation was dated 2/26/2024. An evaluation was due to be conducted on or before 2/26/2025. Four (4) children’s files were reviewed. Three (3) of the children’s files were missing a medical exam and immunizations. 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 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. Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. 10A NCAC 09 .0514(f) 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. Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. 10A NCAC 09 .0302(d)(2) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. .1103(b) Technical assistance was provided as follows: Item 1032- Uncompensated provider hired 6/23/2025 medical report was not completed and on file prior to the first day of employment. We discussed staff members who provide direct care to children counting in staff/child ratio, must have a medical report on file the first day of employment Rule Reference: 10A NCAC 09 .0701(a) Item 1067- Uncompensated provider hired 6/23/2025 did not complete six (6) clock hours of orientation within the first two weeks of employment. We discussed when a new a new provider starts to begin the orientation, and track the required timeframe on your calendar and set a reminder in your phone to ensure the timeline is met. Rule Reference: 10A NCAC 09.1101(a)(b) Item 1232- Staff members personnel file did not contain an annual staff evaluation and a staff development plan. The last staff evaluation on file was dated 2/26/2024. The annual staff evaluation was due to be completed on or before 2/26/2025. We discussed scheduling a day each year and setting a reminder in your phone to ensure the evaluation and staff development plans are completed on the same day each year. Rule Reference: 10A NCAC 09.0514(f) Item 1311- Child enrolled 8/26/2024 and child enrolled 6/27/2022, emergency information was not updated at least annually for each child. We discussed scheduling a day each year for all children to review/update their emergency information. Rule Reference: 10A NCAC 09.0802(c) Item 1321- Child enrolled 8/18/2025 did not have medical report on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have a medical report on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a medical report on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the medical report. Rule Reference: G.S. 110-91(1) Item 1323- Child enrolled 8/18/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 12/4/2025 did not have immunizations records on file within thirty (30) days of enrollment. Child enrolled 8/26/2024 did not have a immunizations records on file within thirty (30) days of enrollment. We discussed when a child is enrolled, tracking thirty (30) days on your calendar or set a reminder in your phone when the child’s thirty (30) days deadline is to submit the immunization records. Rule Reference: 10A NCAC 09.0302(d)(2) Item 1874- Uncompensated provider hired 6/23/2025, Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed prior to caring for children and a signed acknowledgement with all the required information was not on file for review. We discussed any staff member providing care to children and counting in staff/child ratio must have a documentation on file that the center Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed and signed prior to caring for children. The administrator reviewed the policy with the provider during the visit and signed documentation is now on file. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1899- Two (2) staff members health and safety training topic administration of medication training was missing for staff member hired 6/1995, and 4/18/2018. The last completed administration of medication training certificate on file was dated 2/29/2020 and 2/23/2020. We reviewed that this training is listed separate in Moodle and you must register for the Administration of Medication training in addition to the Health and Safety trainings. You may also reach out to Buncombe County Partnership for Children or the local Child Care Health Consultant to provide administration of medication training. Rule Reference: 10A NCAC 09 .1103(b) 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 2/3/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 scheduling a technical assistance visit to review the QRIS modernization. -We reviewed what an uncompensated provider and volunteer means. "Uncompensated provider" means a person who works in a child care facility and is counted in staff/child ratio or has unsupervised contact with children, but who is not monetarily compensated by the facility. An uncompensated provider must be at least 18 years of age and literate. "Volunteer" means a person who works in a child care facility and is not counted in staff/child ratio, does not have unsupervised contact with children, and is not monetarily compensated by the facility. A person who is at least 13 years of age, but less than 16 years age, may work on a volunteer basis, as long as he or she is supervised by and works with a staff person who is at least 21 years of age and meets staff qualification requirements. -Lead Paint and Asbestos Testing: Lead paint portion of the testing shows the facility’s enrollment is started but not completed. You will need to log back onto the system to check on the status of the lead paint testing. In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. - New and terminated staff notification requirement: Continue to update the facility roster has staff members are hired and terminated. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/14/2025 Number Present: 26 Completed Date: 7/14/2025 Age: From 2 To 6 Total Minutes: 185 Time In: 10:10 AM Time Out: 01:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/5/2025. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (Daytime care), meets enhanced space. The last fire drill was practiced on 6/13/2025. The last emergency drill, lockdown drill, was practiced on 5/12/2025. The last fire inspection was approved on 7/16/24. The program’s most recent sanitation inspection was completed on 1/22/2025, with ten (10) demerits. The last lead water testing was completed on 1/31/2025. The last lead paint and asbestos testing was completed on 11/13/2024. The Emergency Medical Care Plan is current and posted. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. In space #1, the group of three- to six-year-olds were engaged in indoor gross motor play. After gross motor play, the group used the restroom and washed hands to gather at the table for story time. The lead teacher read a story to the group. When story time was over, the group prepared for lunch. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #2, the group of three- to five-year-olds were engaged in indoor gross motor play. After gross motor play the group washed hands and prepared for lunch. When lunch concluded the group washed hands and transitioned to their cots to prepare for nap. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #3, the group of two- to three-year-old children were engaged in indoor gross motor play. Then the group transitioned to free play with puzzles, books, and stuffed animals. After free play the group washed hands to prepare for lunch. During nap time, staff assisted a child who was unable to rest while supervising the children. Natural lighting and calming soft music was used to help children rest. The staff held the children and provided quite activities to do on their cots. Lunch today consisted of peanut butter and jelly, mixed vegetables, peaches, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Follow up on additional guidance due to Tropical Storm Helene: The facility is working to make the outdoor environment safe for the children to use. Currently, the facility has removed the debris, the ground leveled, new privacy fence installed, and awaiting for new climbing structure to be installed. While the playground was under repair, the facility provided indoor gross motor play. Today, I measured the new playground space. Space #1 has a capacity ten (10) children at one hundred (100) square feet. Space #2 has a capacity of fifty-two (52) children at one hundred (100) square feet. I observed one (1) wooden privacy fence board needs to be secured to the fence on space #2. The provider reached out to the contractor to secure the board this afternoon. Outdoor play can resume once the board is secured to the fence. The provider will contact me once the board has been secured for final approval. We discussed the importance of children getting outdoors daily. Below is additional information provided by Caring for our children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. The following violations of child care requirements were observed today: Violation Number Comment Rule 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. Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. .0701(a) Technical assistance was provided as follows: Item 1033- Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. We discussed when a staff member returns after an employment separation they must have a current TB test completed and on file. Rule reference: .0701(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/28/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if you mail 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: - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@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. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/14/2025 Number Present: 26 Completed Date: 7/14/2025 Age: From 2 To 6 Total Minutes: 185 Time In: 10:10 AM Time Out: 01:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/5/2025. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (Daytime care), meets enhanced space. The last fire drill was practiced on 6/13/2025. The last emergency drill, lockdown drill, was practiced on 5/12/2025. The last fire inspection was approved on 7/16/24. The program’s most recent sanitation inspection was completed on 1/22/2025, with ten (10) demerits. The last lead water testing was completed on 1/31/2025. The last lead paint and asbestos testing was completed on 11/13/2024. The Emergency Medical Care Plan is current and posted. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. In space #1, the group of three- to six-year-olds were engaged in indoor gross motor play. After gross motor play, the group used the restroom and washed hands to gather at the table for story time. The lead teacher read a story to the group. When story time was over, the group prepared for lunch. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #2, the group of three- to five-year-olds were engaged in indoor gross motor play. After gross motor play the group washed hands and prepared for lunch. When lunch concluded the group washed hands and transitioned to their cots to prepare for nap. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #3, the group of two- to three-year-old children were engaged in indoor gross motor play. Then the group transitioned to free play with puzzles, books, and stuffed animals. After free play the group washed hands to prepare for lunch. During nap time, staff assisted a child who was unable to rest while supervising the children. Natural lighting and calming soft music was used to help children rest. The staff held the children and provided quite activities to do on their cots. Lunch today consisted of peanut butter and jelly, mixed vegetables, peaches, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Follow up on additional guidance due to Tropical Storm Helene: The facility is working to make the outdoor environment safe for the children to use. Currently, the facility has removed the debris, the ground leveled, new privacy fence installed, and awaiting for new climbing structure to be installed. While the playground was under repair, the facility provided indoor gross motor play. Today, I measured the new playground space. Space #1 has a capacity ten (10) children at one hundred (100) square feet. Space #2 has a capacity of fifty-two (52) children at one hundred (100) square feet. I observed one (1) wooden privacy fence board needs to be secured to the fence on space #2. The provider reached out to the contractor to secure the board this afternoon. Outdoor play can resume once the board is secured to the fence. The provider will contact me once the board has been secured for final approval. We discussed the importance of children getting outdoors daily. Below is additional information provided by Caring for our children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. The following violations of child care requirements were observed today: Violation Number Comment Rule 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. Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. .0701(a) Technical assistance was provided as follows: Item 1033- Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. We discussed when a staff member returns after an employment separation they must have a current TB test completed and on file. Rule reference: .0701(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/28/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if you mail 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: - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@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. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/14/2025 Number Present: 26 Completed Date: 7/14/2025 Age: From 2 To 6 Total Minutes: 185 Time In: 10:10 AM Time Out: 01:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/5/2025. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (Daytime care), meets enhanced space. The last fire drill was practiced on 6/13/2025. The last emergency drill, lockdown drill, was practiced on 5/12/2025. The last fire inspection was approved on 7/16/24. The program’s most recent sanitation inspection was completed on 1/22/2025, with ten (10) demerits. The last lead water testing was completed on 1/31/2025. The last lead paint and asbestos testing was completed on 11/13/2024. The Emergency Medical Care Plan is current and posted. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. In space #1, the group of three- to six-year-olds were engaged in indoor gross motor play. After gross motor play, the group used the restroom and washed hands to gather at the table for story time. The lead teacher read a story to the group. When story time was over, the group prepared for lunch. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #2, the group of three- to five-year-olds were engaged in indoor gross motor play. After gross motor play the group washed hands and prepared for lunch. When lunch concluded the group washed hands and transitioned to their cots to prepare for nap. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #3, the group of two- to three-year-old children were engaged in indoor gross motor play. Then the group transitioned to free play with puzzles, books, and stuffed animals. After free play the group washed hands to prepare for lunch. During nap time, staff assisted a child who was unable to rest while supervising the children. Natural lighting and calming soft music was used to help children rest. The staff held the children and provided quite activities to do on their cots. Lunch today consisted of peanut butter and jelly, mixed vegetables, peaches, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Follow up on additional guidance due to Tropical Storm Helene: The facility is working to make the outdoor environment safe for the children to use. Currently, the facility has removed the debris, the ground leveled, new privacy fence installed, and awaiting for new climbing structure to be installed. While the playground was under repair, the facility provided indoor gross motor play. Today, I measured the new playground space. Space #1 has a capacity ten (10) children at one hundred (100) square feet. Space #2 has a capacity of fifty-two (52) children at one hundred (100) square feet. I observed one (1) wooden privacy fence board needs to be secured to the fence on space #2. The provider reached out to the contractor to secure the board this afternoon. Outdoor play can resume once the board is secured to the fence. The provider will contact me once the board has been secured for final approval. We discussed the importance of children getting outdoors daily. Below is additional information provided by Caring for our children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. The following violations of child care requirements were observed today: Violation Number Comment Rule 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. Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. .0701(a) Technical assistance was provided as follows: Item 1033- Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. We discussed when a staff member returns after an employment separation they must have a current TB test completed and on file. Rule reference: .0701(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/28/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if you mail 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: - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@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. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/14/2025 Number Present: 26 Completed Date: 7/14/2025 Age: From 2 To 6 Total Minutes: 185 Time In: 10:10 AM Time Out: 01:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/5/2025. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (Daytime care), meets enhanced space. The last fire drill was practiced on 6/13/2025. The last emergency drill, lockdown drill, was practiced on 5/12/2025. The last fire inspection was approved on 7/16/24. The program’s most recent sanitation inspection was completed on 1/22/2025, with ten (10) demerits. The last lead water testing was completed on 1/31/2025. The last lead paint and asbestos testing was completed on 11/13/2024. The Emergency Medical Care Plan is current and posted. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. In space #1, the group of three- to six-year-olds were engaged in indoor gross motor play. After gross motor play, the group used the restroom and washed hands to gather at the table for story time. The lead teacher read a story to the group. When story time was over, the group prepared for lunch. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #2, the group of three- to five-year-olds were engaged in indoor gross motor play. After gross motor play the group washed hands and prepared for lunch. When lunch concluded the group washed hands and transitioned to their cots to prepare for nap. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #3, the group of two- to three-year-old children were engaged in indoor gross motor play. Then the group transitioned to free play with puzzles, books, and stuffed animals. After free play the group washed hands to prepare for lunch. During nap time, staff assisted a child who was unable to rest while supervising the children. Natural lighting and calming soft music was used to help children rest. The staff held the children and provided quite activities to do on their cots. Lunch today consisted of peanut butter and jelly, mixed vegetables, peaches, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Follow up on additional guidance due to Tropical Storm Helene: The facility is working to make the outdoor environment safe for the children to use. Currently, the facility has removed the debris, the ground leveled, new privacy fence installed, and awaiting for new climbing structure to be installed. While the playground was under repair, the facility provided indoor gross motor play. Today, I measured the new playground space. Space #1 has a capacity ten (10) children at one hundred (100) square feet. Space #2 has a capacity of fifty-two (52) children at one hundred (100) square feet. I observed one (1) wooden privacy fence board needs to be secured to the fence on space #2. The provider reached out to the contractor to secure the board this afternoon. Outdoor play can resume once the board is secured to the fence. The provider will contact me once the board has been secured for final approval. We discussed the importance of children getting outdoors daily. Below is additional information provided by Caring for our children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. The following violations of child care requirements were observed today: Violation Number Comment Rule 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. Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. .0701(a) Technical assistance was provided as follows: Item 1033- Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. We discussed when a staff member returns after an employment separation they must have a current TB test completed and on file. Rule reference: .0701(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/28/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if you mail 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: - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@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. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/14/2025 Number Present: 26 Completed Date: 7/14/2025 Age: From 2 To 6 Total Minutes: 185 Time In: 10:10 AM Time Out: 01:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/5/2025. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (Daytime care), meets enhanced space. The last fire drill was practiced on 6/13/2025. The last emergency drill, lockdown drill, was practiced on 5/12/2025. The last fire inspection was approved on 7/16/24. The program’s most recent sanitation inspection was completed on 1/22/2025, with ten (10) demerits. The last lead water testing was completed on 1/31/2025. The last lead paint and asbestos testing was completed on 11/13/2024. The Emergency Medical Care Plan is current and posted. The program does not provide transportation. Upon arrival, I was greeted by Kathy Tolar, Administrator. A walkthrough of the indoor and outdoor environment was conducted. In space #1, the group of three- to six-year-olds were engaged in indoor gross motor play. After gross motor play, the group used the restroom and washed hands to gather at the table for story time. The lead teacher read a story to the group. When story time was over, the group prepared for lunch. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #2, the group of three- to five-year-olds were engaged in indoor gross motor play. After gross motor play the group washed hands and prepared for lunch. When lunch concluded the group washed hands and transitioned to their cots to prepare for nap. During nap time, staff were stationed to supervise the children. Natural lighting and calming soft music was used to help children rest. If a child was unable to rest the staff provided the children with a quite activity on their cot. In space #3, the group of two- to three-year-old children were engaged in indoor gross motor play. Then the group transitioned to free play with puzzles, books, and stuffed animals. After free play the group washed hands to prepare for lunch. During nap time, staff assisted a child who was unable to rest while supervising the children. Natural lighting and calming soft music was used to help children rest. The staff held the children and provided quite activities to do on their cots. Lunch today consisted of peanut butter and jelly, mixed vegetables, peaches, and milk. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Follow up on additional guidance due to Tropical Storm Helene: The facility is working to make the outdoor environment safe for the children to use. Currently, the facility has removed the debris, the ground leveled, new privacy fence installed, and awaiting for new climbing structure to be installed. While the playground was under repair, the facility provided indoor gross motor play. Today, I measured the new playground space. Space #1 has a capacity ten (10) children at one hundred (100) square feet. Space #2 has a capacity of fifty-two (52) children at one hundred (100) square feet. I observed one (1) wooden privacy fence board needs to be secured to the fence on space #2. The provider reached out to the contractor to secure the board this afternoon. Outdoor play can resume once the board is secured to the fence. The provider will contact me once the board has been secured for final approval. We discussed the importance of children getting outdoors daily. Below is additional information provided by Caring for our children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. The following violations of child care requirements were observed today: Violation Number Comment Rule 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. Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. .0701(a) Technical assistance was provided as follows: Item 1033- Staff member rehired on 6/10/25 did not have a current TB or TB Questionnaire on file for review. The TB test on file was dated 3/29/2019. We discussed when a staff member returns after an employment separation they must have a current TB test completed and on file. Rule reference: .0701(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 7/28/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if you mail 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: - DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@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. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/5/2025 Number Present: 23 Completed Date: 2/5/2025 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-one percent (81%) as of 1/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care LLC, is current/active as of 1/22/2025. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 2/13/2024. The last fire drill was practiced on 1/27/2025. The program missed an October fire drill due to the Tropical Storm Helene facility closure. Since re-opening, the facility has resumed monthly fire drills. The last shelter-in-place drill was practiced on 11/19/2024. The facility was unable to conduct a emergency drill in October due to being closed due to Tropical Storm Helene. When the facility reopened, they conducted an emergency drill. The last playground inspection was documented on 9/18/2024. The facility did not conduct an October inspection due to be closed due to Tropical Storm Helene. Since being re-opened, the facility has not conducted a playground inspection since they are not using the outdoor space. The last fire inspection was approved on 7/16/2024. The last sanitation inspection was conducted on 1/22/2025 with ten (10) demerits for an superior classification. The Emergency Medical Care plan was posted and current. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 11/18/2024. The facility is providing indoor gross motor play due to the extensive damages the outdoor environment sustained due to the storm. In space #1, the group of three- to five-year-olds were engaged in group art at the table. Two (2) therapist and one (1) student therapist were onsite working with the children. After group art, the group transitioned to gross motor music and movement. Then washed hands and prepare for lunch. After lunch, the group used the restroom and transitioned to their cots for nap time. In space #2, the group of three- to five-year-olds were engaged in free play with blocks, dollhouse. After free play, the group worked on their valentine bags. When art concluded, the group transitioned to gross motor music and movement. Then washed hands and prepared for lunch. Lunch consisted of chicken nuggets, green beans, oranges, bread, and milk. In space #3, the group of two- to four-year-old children were engaged in art making valentine bags. After art, the group moved to group time area for social emotional lesson. The group was learning how to take a deep breath to assist with calming down. All staff interactions were positive and nurturing. The facility is working to make the outdoor environment safe for the children to use, but has run into several issues before the new fence can be installed. The provider must contact the landlord to find out where the property line is. Then the provider is having trouble getting someone to remove the remainder of the debris. Once the property line information is received and someone removes the remaining debris, the program must hire someone to grade the playground space in order to level the ground. The administrator stated that she is in the process of getting quotes. The only problem with this is the companies are booked and have a wait time. We discussed that the facility must develop a written plan with timeline to have the outdoor space completed so that the children can return to outdoor gross motor play. The importance of outdoor play is crucial to young children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight, and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. Time spent outdoors has been found to be a strong, consistent predictor of children’s physical activity. Children can accumulate opportunities for activity over the course of several shorter segments of at least 10 minutes each. Free play, active play, and outdoor play are essential components of young children’s development. Children learn through play, developing gross motor, socioemotional, and cognitive skills. During outdoor play, children learn about their environment, science, and nature. Until the program can get the outdoor space back in compliance, the program will provide indoor gross motor play. They currently use active gross motor songs to assist with gross motor play. We discussed adding the use of balls, balancing cups, and steppers. The program does not provide transportation. During today’s visit, I monitored one (1) staff and three (3) children’s files. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604(c) Technical assistance was provided as follows: Item #812 Three (3) electrical outlets were observed uncovered in the office space. The administrator corrected this during the visit by adding outlet covers. We discussed that any electrical outlet, power strip, or outlet box with any unused outlets must be covered with a safety plug. Rule Reference: 10A NCAC 09 .0604(c) Consultation is provided as follows: -Staff evaluations and professional development plans are due by 2/26/2025. -Criminal background checks are due by 2/26/2025 for staff members KT, GF, JL. -Emergency Information and Health questionnaires are due to be updated by 4/15/2025. -Staff member JL administration of medication health and safety training is due by 2/28/2025. -Annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response plan is due by 2/17/2025. -We reviewed the children's applications requirements. Ensure parents completed the health care needs and concerns section along with updating the application annually to ensure that the information is still correct. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/5/2025 Number Present: 23 Completed Date: 2/5/2025 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-one percent (81%) as of 1/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care LLC, is current/active as of 1/22/2025. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 2/13/2024. The last fire drill was practiced on 1/27/2025. The program missed an October fire drill due to the Tropical Storm Helene facility closure. Since re-opening, the facility has resumed monthly fire drills. The last shelter-in-place drill was practiced on 11/19/2024. The facility was unable to conduct a emergency drill in October due to being closed due to Tropical Storm Helene. When the facility reopened, they conducted an emergency drill. The last playground inspection was documented on 9/18/2024. The facility did not conduct an October inspection due to be closed due to Tropical Storm Helene. Since being re-opened, the facility has not conducted a playground inspection since they are not using the outdoor space. The last fire inspection was approved on 7/16/2024. The last sanitation inspection was conducted on 1/22/2025 with ten (10) demerits for an superior classification. The Emergency Medical Care plan was posted and current. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 11/18/2024. The facility is providing indoor gross motor play due to the extensive damages the outdoor environment sustained due to the storm. In space #1, the group of three- to five-year-olds were engaged in group art at the table. Two (2) therapist and one (1) student therapist were onsite working with the children. After group art, the group transitioned to gross motor music and movement. Then washed hands and prepare for lunch. After lunch, the group used the restroom and transitioned to their cots for nap time. In space #2, the group of three- to five-year-olds were engaged in free play with blocks, dollhouse. After free play, the group worked on their valentine bags. When art concluded, the group transitioned to gross motor music and movement. Then washed hands and prepared for lunch. Lunch consisted of chicken nuggets, green beans, oranges, bread, and milk. In space #3, the group of two- to four-year-old children were engaged in art making valentine bags. After art, the group moved to group time area for social emotional lesson. The group was learning how to take a deep breath to assist with calming down. All staff interactions were positive and nurturing. The facility is working to make the outdoor environment safe for the children to use, but has run into several issues before the new fence can be installed. The provider must contact the landlord to find out where the property line is. Then the provider is having trouble getting someone to remove the remainder of the debris. Once the property line information is received and someone removes the remaining debris, the program must hire someone to grade the playground space in order to level the ground. The administrator stated that she is in the process of getting quotes. The only problem with this is the companies are booked and have a wait time. We discussed that the facility must develop a written plan with timeline to have the outdoor space completed so that the children can return to outdoor gross motor play. The importance of outdoor play is crucial to young children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight, and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. Time spent outdoors has been found to be a strong, consistent predictor of children’s physical activity. Children can accumulate opportunities for activity over the course of several shorter segments of at least 10 minutes each. Free play, active play, and outdoor play are essential components of young children’s development. Children learn through play, developing gross motor, socioemotional, and cognitive skills. During outdoor play, children learn about their environment, science, and nature. Until the program can get the outdoor space back in compliance, the program will provide indoor gross motor play. They currently use active gross motor songs to assist with gross motor play. We discussed adding the use of balls, balancing cups, and steppers. The program does not provide transportation. During today’s visit, I monitored one (1) staff and three (3) children’s files. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604(c) Technical assistance was provided as follows: Item #812 Three (3) electrical outlets were observed uncovered in the office space. The administrator corrected this during the visit by adding outlet covers. We discussed that any electrical outlet, power strip, or outlet box with any unused outlets must be covered with a safety plug. Rule Reference: 10A NCAC 09 .0604(c) Consultation is provided as follows: -Staff evaluations and professional development plans are due by 2/26/2025. -Criminal background checks are due by 2/26/2025 for staff members KT, GF, JL. -Emergency Information and Health questionnaires are due to be updated by 4/15/2025. -Staff member JL administration of medication health and safety training is due by 2/28/2025. -Annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response plan is due by 2/17/2025. -We reviewed the children's applications requirements. Ensure parents completed the health care needs and concerns section along with updating the application annually to ensure that the information is still correct. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/5/2025 Number Present: 23 Completed Date: 2/5/2025 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-one percent (81%) as of 1/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care LLC, is current/active as of 1/22/2025. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 2/13/2024. The last fire drill was practiced on 1/27/2025. The program missed an October fire drill due to the Tropical Storm Helene facility closure. Since re-opening, the facility has resumed monthly fire drills. The last shelter-in-place drill was practiced on 11/19/2024. The facility was unable to conduct a emergency drill in October due to being closed due to Tropical Storm Helene. When the facility reopened, they conducted an emergency drill. The last playground inspection was documented on 9/18/2024. The facility did not conduct an October inspection due to be closed due to Tropical Storm Helene. Since being re-opened, the facility has not conducted a playground inspection since they are not using the outdoor space. The last fire inspection was approved on 7/16/2024. The last sanitation inspection was conducted on 1/22/2025 with ten (10) demerits for an superior classification. The Emergency Medical Care plan was posted and current. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 11/18/2024. The facility is providing indoor gross motor play due to the extensive damages the outdoor environment sustained due to the storm. In space #1, the group of three- to five-year-olds were engaged in group art at the table. Two (2) therapist and one (1) student therapist were onsite working with the children. After group art, the group transitioned to gross motor music and movement. Then washed hands and prepare for lunch. After lunch, the group used the restroom and transitioned to their cots for nap time. In space #2, the group of three- to five-year-olds were engaged in free play with blocks, dollhouse. After free play, the group worked on their valentine bags. When art concluded, the group transitioned to gross motor music and movement. Then washed hands and prepared for lunch. Lunch consisted of chicken nuggets, green beans, oranges, bread, and milk. In space #3, the group of two- to four-year-old children were engaged in art making valentine bags. After art, the group moved to group time area for social emotional lesson. The group was learning how to take a deep breath to assist with calming down. All staff interactions were positive and nurturing. The facility is working to make the outdoor environment safe for the children to use, but has run into several issues before the new fence can be installed. The provider must contact the landlord to find out where the property line is. Then the provider is having trouble getting someone to remove the remainder of the debris. Once the property line information is received and someone removes the remaining debris, the program must hire someone to grade the playground space in order to level the ground. The administrator stated that she is in the process of getting quotes. The only problem with this is the companies are booked and have a wait time. We discussed that the facility must develop a written plan with timeline to have the outdoor space completed so that the children can return to outdoor gross motor play. The importance of outdoor play is crucial to young children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight, and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. Time spent outdoors has been found to be a strong, consistent predictor of children’s physical activity. Children can accumulate opportunities for activity over the course of several shorter segments of at least 10 minutes each. Free play, active play, and outdoor play are essential components of young children’s development. Children learn through play, developing gross motor, socioemotional, and cognitive skills. During outdoor play, children learn about their environment, science, and nature. Until the program can get the outdoor space back in compliance, the program will provide indoor gross motor play. They currently use active gross motor songs to assist with gross motor play. We discussed adding the use of balls, balancing cups, and steppers. The program does not provide transportation. During today’s visit, I monitored one (1) staff and three (3) children’s files. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604(c) Technical assistance was provided as follows: Item #812 Three (3) electrical outlets were observed uncovered in the office space. The administrator corrected this during the visit by adding outlet covers. We discussed that any electrical outlet, power strip, or outlet box with any unused outlets must be covered with a safety plug. Rule Reference: 10A NCAC 09 .0604(c) Consultation is provided as follows: -Staff evaluations and professional development plans are due by 2/26/2025. -Criminal background checks are due by 2/26/2025 for staff members KT, GF, JL. -Emergency Information and Health questionnaires are due to be updated by 4/15/2025. -Staff member JL administration of medication health and safety training is due by 2/28/2025. -Annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response plan is due by 2/17/2025. -We reviewed the children's applications requirements. Ensure parents completed the health care needs and concerns section along with updating the application annually to ensure that the information is still correct. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/5/2025 Number Present: 23 Completed Date: 2/5/2025 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-one percent (81%) as of 1/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care LLC, is current/active as of 1/22/2025. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 2/13/2024. The last fire drill was practiced on 1/27/2025. The program missed an October fire drill due to the Tropical Storm Helene facility closure. Since re-opening, the facility has resumed monthly fire drills. The last shelter-in-place drill was practiced on 11/19/2024. The facility was unable to conduct a emergency drill in October due to being closed due to Tropical Storm Helene. When the facility reopened, they conducted an emergency drill. The last playground inspection was documented on 9/18/2024. The facility did not conduct an October inspection due to be closed due to Tropical Storm Helene. Since being re-opened, the facility has not conducted a playground inspection since they are not using the outdoor space. The last fire inspection was approved on 7/16/2024. The last sanitation inspection was conducted on 1/22/2025 with ten (10) demerits for an superior classification. The Emergency Medical Care plan was posted and current. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 11/18/2024. The facility is providing indoor gross motor play due to the extensive damages the outdoor environment sustained due to the storm. In space #1, the group of three- to five-year-olds were engaged in group art at the table. Two (2) therapist and one (1) student therapist were onsite working with the children. After group art, the group transitioned to gross motor music and movement. Then washed hands and prepare for lunch. After lunch, the group used the restroom and transitioned to their cots for nap time. In space #2, the group of three- to five-year-olds were engaged in free play with blocks, dollhouse. After free play, the group worked on their valentine bags. When art concluded, the group transitioned to gross motor music and movement. Then washed hands and prepared for lunch. Lunch consisted of chicken nuggets, green beans, oranges, bread, and milk. In space #3, the group of two- to four-year-old children were engaged in art making valentine bags. After art, the group moved to group time area for social emotional lesson. The group was learning how to take a deep breath to assist with calming down. All staff interactions were positive and nurturing. The facility is working to make the outdoor environment safe for the children to use, but has run into several issues before the new fence can be installed. The provider must contact the landlord to find out where the property line is. Then the provider is having trouble getting someone to remove the remainder of the debris. Once the property line information is received and someone removes the remaining debris, the program must hire someone to grade the playground space in order to level the ground. The administrator stated that she is in the process of getting quotes. The only problem with this is the companies are booked and have a wait time. We discussed that the facility must develop a written plan with timeline to have the outdoor space completed so that the children can return to outdoor gross motor play. The importance of outdoor play is crucial to young children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight, and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. Time spent outdoors has been found to be a strong, consistent predictor of children’s physical activity. Children can accumulate opportunities for activity over the course of several shorter segments of at least 10 minutes each. Free play, active play, and outdoor play are essential components of young children’s development. Children learn through play, developing gross motor, socioemotional, and cognitive skills. During outdoor play, children learn about their environment, science, and nature. Until the program can get the outdoor space back in compliance, the program will provide indoor gross motor play. They currently use active gross motor songs to assist with gross motor play. We discussed adding the use of balls, balancing cups, and steppers. The program does not provide transportation. During today’s visit, I monitored one (1) staff and three (3) children’s files. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604(c) Technical assistance was provided as follows: Item #812 Three (3) electrical outlets were observed uncovered in the office space. The administrator corrected this during the visit by adding outlet covers. We discussed that any electrical outlet, power strip, or outlet box with any unused outlets must be covered with a safety plug. Rule Reference: 10A NCAC 09 .0604(c) Consultation is provided as follows: -Staff evaluations and professional development plans are due by 2/26/2025. -Criminal background checks are due by 2/26/2025 for staff members KT, GF, JL. -Emergency Information and Health questionnaires are due to be updated by 4/15/2025. -Staff member JL administration of medication health and safety training is due by 2/28/2025. -Annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response plan is due by 2/17/2025. -We reviewed the children's applications requirements. Ensure parents completed the health care needs and concerns section along with updating the application annually to ensure that the information is still correct. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/5/2025 Number Present: 23 Completed Date: 2/5/2025 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-one percent (81%) as of 1/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care LLC, is current/active as of 1/22/2025. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 2/13/2024. The last fire drill was practiced on 1/27/2025. The program missed an October fire drill due to the Tropical Storm Helene facility closure. Since re-opening, the facility has resumed monthly fire drills. The last shelter-in-place drill was practiced on 11/19/2024. The facility was unable to conduct a emergency drill in October due to being closed due to Tropical Storm Helene. When the facility reopened, they conducted an emergency drill. The last playground inspection was documented on 9/18/2024. The facility did not conduct an October inspection due to be closed due to Tropical Storm Helene. Since being re-opened, the facility has not conducted a playground inspection since they are not using the outdoor space. The last fire inspection was approved on 7/16/2024. The last sanitation inspection was conducted on 1/22/2025 with ten (10) demerits for an superior classification. The Emergency Medical Care plan was posted and current. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 11/18/2024. The facility is providing indoor gross motor play due to the extensive damages the outdoor environment sustained due to the storm. In space #1, the group of three- to five-year-olds were engaged in group art at the table. Two (2) therapist and one (1) student therapist were onsite working with the children. After group art, the group transitioned to gross motor music and movement. Then washed hands and prepare for lunch. After lunch, the group used the restroom and transitioned to their cots for nap time. In space #2, the group of three- to five-year-olds were engaged in free play with blocks, dollhouse. After free play, the group worked on their valentine bags. When art concluded, the group transitioned to gross motor music and movement. Then washed hands and prepared for lunch. Lunch consisted of chicken nuggets, green beans, oranges, bread, and milk. In space #3, the group of two- to four-year-old children were engaged in art making valentine bags. After art, the group moved to group time area for social emotional lesson. The group was learning how to take a deep breath to assist with calming down. All staff interactions were positive and nurturing. The facility is working to make the outdoor environment safe for the children to use, but has run into several issues before the new fence can be installed. The provider must contact the landlord to find out where the property line is. Then the provider is having trouble getting someone to remove the remainder of the debris. Once the property line information is received and someone removes the remaining debris, the program must hire someone to grade the playground space in order to level the ground. The administrator stated that she is in the process of getting quotes. The only problem with this is the companies are booked and have a wait time. We discussed that the facility must develop a written plan with timeline to have the outdoor space completed so that the children can return to outdoor gross motor play. The importance of outdoor play is crucial to young children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight, and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. Time spent outdoors has been found to be a strong, consistent predictor of children’s physical activity. Children can accumulate opportunities for activity over the course of several shorter segments of at least 10 minutes each. Free play, active play, and outdoor play are essential components of young children’s development. Children learn through play, developing gross motor, socioemotional, and cognitive skills. During outdoor play, children learn about their environment, science, and nature. Until the program can get the outdoor space back in compliance, the program will provide indoor gross motor play. They currently use active gross motor songs to assist with gross motor play. We discussed adding the use of balls, balancing cups, and steppers. The program does not provide transportation. During today’s visit, I monitored one (1) staff and three (3) children’s files. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604(c) Technical assistance was provided as follows: Item #812 Three (3) electrical outlets were observed uncovered in the office space. The administrator corrected this during the visit by adding outlet covers. We discussed that any electrical outlet, power strip, or outlet box with any unused outlets must be covered with a safety plug. Rule Reference: 10A NCAC 09 .0604(c) Consultation is provided as follows: -Staff evaluations and professional development plans are due by 2/26/2025. -Criminal background checks are due by 2/26/2025 for staff members KT, GF, JL. -Emergency Information and Health questionnaires are due to be updated by 4/15/2025. -Staff member JL administration of medication health and safety training is due by 2/28/2025. -Annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response plan is due by 2/17/2025. -We reviewed the children's applications requirements. Ensure parents completed the health care needs and concerns section along with updating the application annually to ensure that the information is still correct. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/5/2025 Number Present: 23 Completed Date: 2/5/2025 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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, Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kathy Tolar, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-one percent (81%) as of 1/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Kathy’s Kiddieland Child Care LLC, is current/active as of 1/22/2025. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 2/13/2024. The last fire drill was practiced on 1/27/2025. The program missed an October fire drill due to the Tropical Storm Helene facility closure. Since re-opening, the facility has resumed monthly fire drills. The last shelter-in-place drill was practiced on 11/19/2024. The facility was unable to conduct a emergency drill in October due to being closed due to Tropical Storm Helene. When the facility reopened, they conducted an emergency drill. The last playground inspection was documented on 9/18/2024. The facility did not conduct an October inspection due to be closed due to Tropical Storm Helene. Since being re-opened, the facility has not conducted a playground inspection since they are not using the outdoor space. The last fire inspection was approved on 7/16/2024. The last sanitation inspection was conducted on 1/22/2025 with ten (10) demerits for an superior classification. The Emergency Medical Care plan was posted and current. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 11/18/2024. The facility is providing indoor gross motor play due to the extensive damages the outdoor environment sustained due to the storm. In space #1, the group of three- to five-year-olds were engaged in group art at the table. Two (2) therapist and one (1) student therapist were onsite working with the children. After group art, the group transitioned to gross motor music and movement. Then washed hands and prepare for lunch. After lunch, the group used the restroom and transitioned to their cots for nap time. In space #2, the group of three- to five-year-olds were engaged in free play with blocks, dollhouse. After free play, the group worked on their valentine bags. When art concluded, the group transitioned to gross motor music and movement. Then washed hands and prepared for lunch. Lunch consisted of chicken nuggets, green beans, oranges, bread, and milk. In space #3, the group of two- to four-year-old children were engaged in art making valentine bags. After art, the group moved to group time area for social emotional lesson. The group was learning how to take a deep breath to assist with calming down. All staff interactions were positive and nurturing. The facility is working to make the outdoor environment safe for the children to use, but has run into several issues before the new fence can be installed. The provider must contact the landlord to find out where the property line is. Then the provider is having trouble getting someone to remove the remainder of the debris. Once the property line information is received and someone removes the remaining debris, the program must hire someone to grade the playground space in order to level the ground. The administrator stated that she is in the process of getting quotes. The only problem with this is the companies are booked and have a wait time. We discussed that the facility must develop a written plan with timeline to have the outdoor space completed so that the children can return to outdoor gross motor play. The importance of outdoor play is crucial to young children. Outdoor play is not only an opportunity for learning in a different environment; it also provides many health benefits. Outdoor play allows for physical activity that supports maintenance of a healthy weight, and better nighttime sleep. Short exposure of the skin to sunlight promotes the production of vitamin D that growing children require. Time spent outdoors has been found to be a strong, consistent predictor of children’s physical activity. Children can accumulate opportunities for activity over the course of several shorter segments of at least 10 minutes each. Free play, active play, and outdoor play are essential components of young children’s development. Children learn through play, developing gross motor, socioemotional, and cognitive skills. During outdoor play, children learn about their environment, science, and nature. Until the program can get the outdoor space back in compliance, the program will provide indoor gross motor play. They currently use active gross motor songs to assist with gross motor play. We discussed adding the use of balls, balancing cups, and steppers. The program does not provide transportation. During today’s visit, I monitored one (1) staff and three (3) children’s files. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604(c) Technical assistance was provided as follows: Item #812 Three (3) electrical outlets were observed uncovered in the office space. The administrator corrected this during the visit by adding outlet covers. We discussed that any electrical outlet, power strip, or outlet box with any unused outlets must be covered with a safety plug. Rule Reference: 10A NCAC 09 .0604(c) Consultation is provided as follows: -Staff evaluations and professional development plans are due by 2/26/2025. -Criminal background checks are due by 2/26/2025 for staff members KT, GF, JL. -Emergency Information and Health questionnaires are due to be updated by 4/15/2025. -Staff member JL administration of medication health and safety training is due by 2/28/2025. -Annual review of the Emergency Medical Care Plan and Emergency Preparedness and Response plan is due by 2/17/2025. -We reviewed the children's applications requirements. Ensure parents completed the health care needs and concerns section along with updating the application annually to ensure that the information is still correct. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/12/2024 Number Present: 25 Completed Date: 8/12/2024 Age: From 2 To 7 Total Minutes: 215 Time In: 10:55 AM Time Out: 02:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/13/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the walk through I monitored the indoor and outdoor environment used by the children. In space #1, the group of three- to five year- olds were prepared for lunch at the table. Lunch arrived at 11:00a. In space #2, the group of three- to seven-year-olds were eating lunch at the table. After lunch, the children washed hands, and transitioned to their cots for nap time. In space #3, the group of two- to four-year-old children were washing hands and transitioning to the tables for lunch. After lunch, the children washed hands and transitioned to their cot for nap. All staff interactions were positive and nurturing. The lunch today was ravioli, green beans, carrots, and milk. The last fire drill was practiced on 7/22/2024. The last emergency drill, lockdown drill, was practiced on 7/29/2024. The last fire inspection was approved on 7/16/2024. Fire inspection was completed late. The previous inspection was dated 6/14/2023. The program’s most recent sanitation inspection was completed on 1/5/2024, with approved (24) demerits. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The program does not provide transportation. The license showed that the facility is approved for transportation. However, Kathy Tolar, Administrator asked that transportation be removed from the license. Transportation was removed from the license during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. File concerns: Staff member hired 6/1/1995 missing five (5) year renewal of Emergency Preparedness and Response, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings. On-going training house were completed late. Ten (10) hours will be due by 6/1/2025. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels .0601(c) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. .1103(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch depth around the larger climber on the preschool playground was compacted and low. .0605(k)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. .1103(b) Achieving Compliance: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/26/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #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. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. -Current fire inspection dated 7/16/2024 was completed late. Previous fire inspection was completed 6/14/2023. The administrator stated that the Fire Marshal said that they were short staffed and he from Asheville and filling to help out. I suggest continuing to reach out to the Fire Marshal two (2) months prior to the previous fire inspection completion date. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. -Toddler playground had a radio flyer with torn canopy, missing handle grip, and rust showing. On the preschool playground, the purple tray was broken and cracked with sharp edges, and plastic CAT truck missing wheels. Staff removed this during the visit. I suggest conducting a daily playground check prior to children engaging in outdoor gross motor play. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education Experience Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university Required Training hours 5 clock hours. Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential Required Training hours 8 clock hours. Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential Required Training hours 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement Required Training hours 15 clock hours If none of the other criteria in this chart apply Required 20 clock hours -Staff member hired 6/1/1995 on-going training hours were completed late. Training hours were completed July 26, 2024 for the 2023-2024 fiscal year. Staff member hired 4/24/2018 on-going training hours were completed late. Training hours were completed 5/4/2024 for the 2023-2024 fiscal year. I suggest documenting each staff members training due date on your calendar to keep track of when each person is due. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. -Mulch depth around the larger climber on the preschool playground was compacted and low. I suggest tilling the mulch or having new mulch brought in to put at the slide exits and fall zones. Item #1899 Health and safety training topics were not included as part of on- going training within five years of completing the previous health and safety training topics. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member hired 6/1/1995 Health and Safety training topics for Emergency Preparedness and Response Training, Shaken Baby and Abusive Head Trauma, and Child Abuse trainings were due to by August of 2023. Staff member stated that she has completed the trainings certificate were not on file for review. She attempted to log into her account during the visit but was unable to access her account. She contacted NCID support to assist with unlocking her account and is awaiting a return call. I suggest documenting on a training calendar when each training is due and when completed print the certificate or training transcript to add to your file. Consultation: Today, we discussed the following: -Reminders- Staff member hired 8/22/2023 health and safety trainings due by 8/22/2024 and Professional Development Plan due by 8/22/2024. Criminal Background check due by 11/26/2024. -Professional Development Plans ensure that each has the specific date it was completed on. Then ensure that it is completed annually from that date. -Confidential file stored separately from personnel files should contain health questionnaire, TB, and medical report. -On-going training hours are due by the anniversary date of employment the next year (ex. Staff member hired 6/1/1995 training hours are due by June 1st each year). -Health and Safety trainings are due every five (5) years from the completion date on the certificate. -First Aid and CPR training is due by the date on the card. -Gate to administrator desk area needs to be closed at all times to ensure children do not go into that area. -Activity plans are to be updated and posted weekly. Activity plans must include sand/water activity, gross motor activity, and foundation goals. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0607 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1104 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/13/2024 Number Present: 25 Completed Date: 2/13/2024 Age: From 2 To 5 Total Minutes: 245 Time In: 09:40 AM Time Out: 01:45 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 Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Kathy Tolar, Administrator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-eight percent (78%) as of 2/12/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Kathy’s Kiddieland Child Care Center, LLC., is current/active as of 2/12/2024. Permit type – Three (3) Star Rated License, issued 1/13/2021. Special Services/Restrictions – First shift (daytime care), and meets enhanced space. The last annual compliance visit was conducted on 2/24/2023. The last fire drill was practiced on 1/21/2024. The last lockdown drill was practiced on 1/18/2024. The last playground inspection was documented on 1/2/2024. The last fire inspection was approved on 6/14/2023. The last sanitation inspection was conducted on 1/5/2024 with twenty-four (24) demerits for a approved classification. The Emergency Medical Care plan was posted. However, the Emergency Medical Care plan needs to be updated to reflect the current staff employed at the facility. All medications were monitored during today’s visit. In space #1, the group of three- to five-year-olds were engaged in a group story time. After story time, the group transitioned to free choice center play with free art, legos, paw patrols, and books. Then the children began cleaning up to use the restroom, wash hands, and prepare for lunch. The children then sat at the table for lunch. After lunch, the children cleaned up and washed hands for nap. In space #2, the group of three- to five-year-olds were engaged in free choice center play with books, magnetic blocks, puzzles, train, plastic animals. After free choice center play, the group engaged in music and movement before lunch. In space #3, the group of two- to four-year-old children were engaged in a group activity working on learning their colors. After the group activity, the children transitioned to free choice center play with little people tree, dollhouse, and legos. All staff interactions were positive and nurturing. Lunch consisted of chicken patty, bread, mixed vegetables, mandarin oranges, and milk. Today, I monitored two (2) existing staff file, and three (3) children’s files. Staff file concerns were staff member GF professional development and staff evaluation were not completed annually. Then the EPR and emergency medical care plan was not reviewed annually. Staff member MM first aid and CPR training was not completed with in the first ninety days of employment. 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 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. 10A NCAC 09 .0802(a) 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. Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023 .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. Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. .1102(d) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. .1104 Technical assistance was provided as follows: Item #862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (a) Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. - The emergency medical care plan was not updated and reviewed with staff annually. The last review was completed on 1/13/2023. I suggest pre-planning the review of the emergency medical care plan and documenting it on your calendar as a reminder to complete. Item # 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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete First Aid training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #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. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member MM did not complete CPR training within the first ninety (90) days of employment. The training completion date was 2/4/2024 and was due by 11/10/2023. I suggest when a new staff member is hired to document on your calendar the ninety (90) day deadline to remind you that the staff member must complete the training by that date. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member GF staff evaluation was not completed annually. The administrator stated that she did not complete these this year. I suggest pre-planning a date to complete and review the staff evaluation with each staff member. Document the date on your calendar as a reminder. Item #1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. - Staff member GF did not review the center’s EPR plan on an annual basis. The last review on file was dated 1/13/2023. I suggest pre-planning a date to review the plan with staff and note it on the calendar as a reminder. Item #1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. - Staff member GF professional development plan was not completed annually. The last professional development plan documented was dated 3/3/2022. I suggest pre-planning a date to review the professional development plan with staff and note it on the calendar as a reminder. 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 2/27/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We discussed that you are a part of Cohort 1 for rated license reassessments. The programs year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. The administrator would like to voluntarily begin the rated license based on the staff’s education. I will share the application with you via email. - Emergency Information and Health Questionnaire are due to be completed for staff members KT, GF, and JL by April 6, 2024. - On-going training hours are due by 9/25/2024 for staff member GF. - Emergency medical care plan needs to be updated to reflect the staff currently employed and remove the former staff members. Then review the plan with the staff and document the date the plan was reviewed with staff. - Professional development plan and staff evaluations are due to be completed annually. You need to go ahead and schedule a date to complete these with staff to ensure you are in compliance. - Special diet for children’s dietary needs. I recommend having the doctor complete the General Medical Action Plan to document the child’s dietary needs and what foods can be an alternative for the child to have. - Blanket travel and activity authorizations for playing outside the fenced in area can only be valid for a twelve (12) month time frame (ex. 9/1/2023-9/1/2024). - Outside when trash bags are there, I suggest removing the bags every week or when the bag becomes full. - Over the Counter topical medication authorizations can only be valid for a twelve (12) month time frame (ex. 8/1/2023 to 8/1/2024). - Child EB and TB enrolled 2/1/2024 medical report and immunizations is due by 3/1/2024. - Sand and Water play should be offered weekly and documented on the activity plans. 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. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0607 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0714 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1101 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09. 0803 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-105 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: KATHY'S KIDDIELAND Facility ID: 11000879 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/17/2023 Number Present: 32 Completed Date: 8/17/2023 Age: From 2 To 5 Total Minutes: 305 Time In: 09:20 AM Time Out: 02:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kathy Tolar, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kathy Tolar, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Three (3) Star Rated License effective 1/13/2021. The permit restrictions were in compliance including first shift, meets enhanced space. Kathy Tolar, Administrator, was on-site and available to assist with questions. The program’s annual compliance visit was conducted on 2/24/2023. The following items were monitored today: Supervision Staff / Child Ratio 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 Permit Restrictions Upon arrival, I introduced myself to Ginger Ferguson, Cook who was covering the classroom for Kathy Tolar, Administrator and Lead Teacher. When Ms. Tolar returned, I explained the reason for my visit. In space #1, the group of three- to five-year-olds were on the carpet preparing to transition to the restroom. After using the restroom, the group prepared to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. In space #2, the group of three- to four-year-olds were engaged in group music time. After group music, the group prepare to transition outdoors for gross motor play. Once outside, the group engaged in play with the climber, coupe cars, tunnel, balance beam, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. In space #3, the group of two- to four-year-old children were engaged in cleaning up from breakfast and preparing to go outside. Once outside, the group engaged in play with the balls, trikes, climber, slides, and little tikes playhouse. Then the group transitioned indoors to wash hands and prepare for lunch. All staff interactions were positive and nurturing. Lunch today was beef pasta, corn, tossed salad, toast, and milk. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed during the visit for the new staff member. The last fire drill was practiced on 7/28/2023. The last emergency drill, lockdown drill, was practiced on 7/31/2023. The last fire inspection was approved on 6/14/2023. The program’s most recent sanitation inspection was completed on 3/20/2023, with ten (10) demerits. The Emergency Preparedness and Response plan was revised last on 4/10/2022. The following violations of child care requirements were observed today: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. GS 110-91(6); .0605((i) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. .0803(12) 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. Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. 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. Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. .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. Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. .1101(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. .1101(a)(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. .0608(d)(1-4) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 8/31/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (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. - The fence height on outdoor space #2, measured three (3) feet six (6) inches in the front right corner, three (3) feet four (4) inches in the back left corner, three (3) feet nine (9) inches and three (3) feet ten (10) inches on the front side near the gate. Item 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be stored out of reach of children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use, but are not required to be in locked storage. - In space # 3, prescription medication Triamcholone Acetonide Ointment, and a non prescription medication Hydrocortisone Anti-Itch Cream were unlocked above the diaper changing area in a clear three drawer storage container. Item 847 Parent's medication authorization did not include required information. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (4) Over-the-counter medications, such as cough syrup, decongestant, acetaminophen, ibuprofen, topical antibiotic cream for abrasions, or medication for intestinal disorders shall be stored in the manufacturer's original packaging on which the child's name is written or labeled and shall be accompanied by written instructions specifying: (a) the child's name; (b) the names of the authorized over-the-counter medication; (c) the amount and frequency of the dosages, which shall not exceed the amount and frequency of the dosages on the manufacturer's label; (d) the signature of the parent, physician or other health professional; and (e) the date the instructions were signed by the parent, physician or other health professional. The permission to administer over-the-counter medications is valid for up to 30 days at a time, except as allowed in Items (6), (7), (8) and (9) of this Rule. Over-the-counter medications shall not be administered on an "as needed" basis, other than as allowed in Items (6), (7), (8) and (9) of this Rule. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (9) A parent may give a caregiver standing authorization to administer an over-the-counter medication as directed by the North Carolina State Health Director or designee, when there is a public health emergency as identified by the North Carolina State Health Director or designee. The authorization shall be in writing, may be valid for as long as the child is enrolled, and shall contain: (a) the child's name; (b) the signature of the parent; (c) the date the authorization was signed by the parent; and (d) the date that the authorization ends or a statement that the authorization is valid until withdrawn by the parent in writing. - In space #3, child RC Hydrocortisone Anti-Itch cream permission to administer medication form did not contain the medication name, dosage amount, expiration date, and when to apply the medication. Item 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #3, child RC hydrocortisone Anti-Itch cream expired 5/2017, child CG Aquaphor expired 1/2022, and child EM Desitin expired 5/2022. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MM hired 6/12/2023 did not have a medical report on file prior to employment. Item 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 they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. - Staff member MM hired 6/12/2023 did not have a TB on file prior to employment. Item 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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers Item Requirements: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. - Staff member MM hired 6/12/2023 did not have a emergency information on or before the first day of work. The staff member completed the emergency information form during today’s visit. Item 1045 New staff who have contact with children, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. - Staff member MM hired 6/12/2023 did not complete each topic required for the first six weeks of employment. The staff member is missing the following topics: Firsthand observation of the center’s daily operations, Instruction in the administration of medication to children in accordance with 10A NCAC 09. 0803, Prevention of and response to emergencies due to food and allergic reactions, Review of the center’s handling and storage of hazardous materials and the appropriate disposal of biocontaminants, Information about criminal history mandatory reporting. Item 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: New staff orientation within first two (2) weeks of employment: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301; Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan; Adequate supervision of children in accordance with 10A NCAC 09 .1801; Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment; Prevention and control of infectious diseases, including immunization. New staff orientation within first six (6) weeks of employment Firsthand observation of the center's daily operations; Instruction in the employee's assigned duties; Instruction in the maintenance of a safe and healthy environment; Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803; Review of the center's purposes and goals; Review of the child care licensing law and rules; Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment; An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource; An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations; Prevention of and response to emergencies due to food and allergic reactions; Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. - Staff member MM hired 6/12/2023 did not complete each topic required for the first two weeks of employment. The staff member is missing the following topics: Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment, and Prevention and control of infectious diseases, including immunizations. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - The center Emergency Preparedness and Response Plan was not updated annually. The last revision date was 4/10/2022. Item 1874 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. - Staff member MM hired 6/12/2023 did not review and complete the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy prior to caring for children. The policy was reviewed, and form completed during the visit on 8/17/2023. Consultation: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 1. The year of preparation began July 1, 2023, and will end on June 30, 2024. The year of assessment will begin July 1, 2024, and end June 30, 2025. Be sure to take advantage of the preparation year assessment during your preparation year. - Plan a day to update the Emergency Preparedness and Response plan and Emergency Medical Care plan each year and review with staff. Then add it to your hard copy and electronic calendar to ensure you complete it on that date. - Review with staff the required times for hand washing to take place with both children and staff. - I recommend having the staff review the medication administration training on Moodle or have Chrissy Wolff, Child Care Health Consultant come conduct a training. - In order to correct the fence height, I recommend adding lattice, fence piping, or a fence extender to the top of the fence. - Ensure you are able to access the Risk Management Portal with the correct username and ID. If you are unable to access the account that shows your previous plan, I recommend contacting the help desk for assistance. - Administrator are required to work on-site weekly for 25 hours for a licensed capacity of 47 children. Ensure you have coverage to provide you with time to leave staff/child ratio to conduct administrative duties throughout the week. 10A NCAC 09 .0714 OTHER STAFFING REQUIREMENTS (a) Each child care center shall have a child care administrator who shall be responsible for monitoring the program and overseeing administrative duties of the center. This requirement may be met by having one or more persons on site who meet the requirements for a child care administrator as set forth in G.S. 110-91(8) and according to the licensed capacity of the center. The child care administrator shall be on-site in accordance with the following chart: Licensed Capacity Weekly On-Site Hours Less than 30 children 20 30-79 children 25 80-199 children 30 200 or more children 40 The child care administrator’s required weekly hours may include those hours that he or she is off-site due to administrative duties, illness or vacation. - Remember I am available to provide training and technical assistance to staff. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times