10A NCAC 09 .0802 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 1/13/2025 Number Present: 9 Completed Date: 1/13/2025 Age: From 1 To 4 Total Minutes: 165 Time In: 09:45 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during the Annual Compliance Visit. Upon arrival at the center, I was greeted at the front entrance by the operator, Ms. Joy. The center located within a residence maintained a five-star rated license and continued to meet enhanced space and ratios. The Annual Compliance Monitoring Checklist for Child Care Centers and the Child Care Item Number Listing dated November 2024 were used to document compliance. Spaces #1-2, kitchen, bathroom and an outdoor learning environment were monitored for compliance. Transportation for children is not provided unless in an emergency. Dotted paint was monitored stored midway on the shelf in space #2. The material was developmentally appropriate for children three years and up. Ms. Joy stated any materials developmentally appropriate for children under three years of age should be stored out of reach. Children were monitored, engaged in eating breakfast of Turkey sausage, blueberries, hash browns, milk and water. Children were also observed obtaining services. The therapist remained in the classroom with the caregiver and children. Eleven children were enrolled. Two children’s records were selected by the consultant and monitored for compliance. The center’s approved and implemented curriculum continued to be Experience Curriculum formerly known as Mother Goose. The posted lesson plan was monitored current with Foundation goals listed. One child was monitored with prescribed medications on site. The Community Health Nurse, Ms. Brown assisted Ms. Joy in reviewing her prescribed medications and forms maintained on site. Medication, permission slip and medical action plans were monitored current. Staff and Training worksheets were presented. The CLAIR form was not completed by the operator. I requested the operator fill in the CLAIR, save it and update it as things expire this next year. Statements of Responsibility were completed during the visit. One new staff member was hired in November 2024 and her file was monitored for compliance. The center’s EPR plan was monitored for compliance and current. The EPR ready to go file were monitored for compliance. It was recommended to print the checklist and keep it in the ready to go file. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored The daily attendance with children’s arrival and departure times were monitored documented and current for today and maintained on a clip board at the front entrance. The outdoor learning environment was monitored for compliance. Monthly inspections were conducted and compliance issued noted and corrected. There was one wooden structure anchored to the ground. The structure appeared tilted. However, upon closer inspection the structure needs additional mulch to flush it with the ground. The mulch was monitored semi-compacted. A snow/ice storm occurred over the weekend. The last sanitation inspection was conducted July 18, 2024, zero (0) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on January 23, 2024. It was recommended to begin the annual inspection process 4-6 weeks prior to expiration. Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. Developmentally appropriate paint dots were accessible to two-year-old child. The label stated three years and older. The paint was relocated to out of reach on a higher shelf in space #2 during the visit. .0510 (e ) (1)(A-G) 832 There was no written emergency medical care (EMC) plan. The plan posted in space #2 was not current. It was removed during the visit and the current plan was posted at entrance of facility in space #1 during the visit. 10A NCAC 09 .0802(a) Technical Assistance Provided and General Discussion: 1. It was recommended to purchase the third edition of FDCERS. There are several resources available on the NCRLAP website at www.NCRLAP.org. It was recommended to take advantage of the training available in the New Year. 2. Ms. Joy was asked to print a roster report from ABCMS. Ms. Joy stated she was still in the process with the staff. Some NCID issues were identified and in process. It was recommended to have each member of staff work on any needed updates along with Ms. Joy at the computer versus staff trying to complete the process via their cell phones or on their own. It was explained that a roster report must be maintained and current. 3. It was recommended to update the daily schedule to reflect the change in meals offered and general times they are served to children. 4. It was recommended to post at the main center board the center emergency medical care plan. There was one posted in space #2 but was not current. The current form was posted in space #1. The old form was removed and thrown away during the visit. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

10A NCAC 09 .0713 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: 0224-076L Visit Date: 2/12/2024 Number Present: 11 Completed Date: 2/12/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:30 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate allegations of violations of child care requirements. Upon arrival I was greeted at the front door by Ms. Miller. Ms. Miller was observed with six children present, ranging in age from six months to two years of age in space #1. Ms. Joy was in space #2 with four children, ranging in age two years to four years of age. Two additional preschool children arrived shortly thereafter. The following allegations were read aloud to Ms. Parks: There is a concern that the center is out of ratios during the morning. Ms. Parks stated a child was sent to just wash his hands. I asked isn’t there a bathroom directly located off of space #2? Ms. Parks stated she was in the bathroom. Child care Rule. 0713(b) was reviewed with Ms. Parks. Daily sign in and out were monitored to discern average arrival times of children. Ms. Parks stated some issues with staffing over the last couple of weeks. A substitute was in place but didn’t show up to work and has not heard from her since. The majority of children arrive between 8:00 am and 9:00 am daily. There were arrival times where seven children were on site by 9:00 am. I inquired about utilizing her husband who is visually impaired. I reviewed the supervision child care rule with Ms. Parks, and we discussed how he could be used to help provide substitute care if a staff person is late or calls out due to illness or circumstances. Currently, Mr. Parks only meets the qualifications of a household member. We also discussed altering the other lead teacher’s daily schedule. A substitute file checklist was emailed to Ms. Parks during the visit. Three staff, including Ms. Parks, were interviewed. Staff stated there were times when Ms. Parks was present in space #1 with seven children present ranging in age from six months to two years of age. Based on my observations and discussions with three staff the allegation of the center being out of ratio during the morning was SUBSTANTIATED. Today, there were six children located in space #1 with one caregiver. The youngest age of the child present was six months. The required ratio was 1:5. Two children were relocated to space #2 to rectify the staff to child ratio violation. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. Upon arrival, there were six children with one caregiver located in space #1. The children ranged in age from six months to two years of age. Two, two-year-old children were relocated to space #2. 10A NCAC 09 .2818 Technical Assistance Provided and General Discussion: 1. It was recommended to develop a communication policy or process to communicate with families in the mornings if a staffing issue arises and there is not adequate staff to maintain the required staff to child ratios. Families should be informed if there is not adequate staff present to maintain the required ratios. 2. We discuss continuing to utilize substitution companies to help with staffing when an immediate need arises. 3. It was recommended to review the daily schedules for the two existing staff and begin working to get your husband qualified as a substitute caregiver for an emergency. 4. We reviewed the child care supervision rule and staff to child ratio child care rules: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. History Note: Authority G.S. 110-85; 110-91(7); 143B-168.3; 5. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 6. We discussed based on the substantiation; an administrative action would be required based on DCDEE procedures. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Monday, February 26, 2024. You may email me your letter of correction. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1801 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: 0224-076L Visit Date: 2/12/2024 Number Present: 11 Completed Date: 2/12/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:30 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate allegations of violations of child care requirements. Upon arrival I was greeted at the front door by Ms. Miller. Ms. Miller was observed with six children present, ranging in age from six months to two years of age in space #1. Ms. Joy was in space #2 with four children, ranging in age two years to four years of age. Two additional preschool children arrived shortly thereafter. The following allegations were read aloud to Ms. Parks: There is a concern that the center is out of ratios during the morning. Ms. Parks stated a child was sent to just wash his hands. I asked isn’t there a bathroom directly located off of space #2? Ms. Parks stated she was in the bathroom. Child care Rule. 0713(b) was reviewed with Ms. Parks. Daily sign in and out were monitored to discern average arrival times of children. Ms. Parks stated some issues with staffing over the last couple of weeks. A substitute was in place but didn’t show up to work and has not heard from her since. The majority of children arrive between 8:00 am and 9:00 am daily. There were arrival times where seven children were on site by 9:00 am. I inquired about utilizing her husband who is visually impaired. I reviewed the supervision child care rule with Ms. Parks, and we discussed how he could be used to help provide substitute care if a staff person is late or calls out due to illness or circumstances. Currently, Mr. Parks only meets the qualifications of a household member. We also discussed altering the other lead teacher’s daily schedule. A substitute file checklist was emailed to Ms. Parks during the visit. Three staff, including Ms. Parks, were interviewed. Staff stated there were times when Ms. Parks was present in space #1 with seven children present ranging in age from six months to two years of age. Based on my observations and discussions with three staff the allegation of the center being out of ratio during the morning was SUBSTANTIATED. Today, there were six children located in space #1 with one caregiver. The youngest age of the child present was six months. The required ratio was 1:5. Two children were relocated to space #2 to rectify the staff to child ratio violation. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. Upon arrival, there were six children with one caregiver located in space #1. The children ranged in age from six months to two years of age. Two, two-year-old children were relocated to space #2. 10A NCAC 09 .2818 Technical Assistance Provided and General Discussion: 1. It was recommended to develop a communication policy or process to communicate with families in the mornings if a staffing issue arises and there is not adequate staff to maintain the required staff to child ratios. Families should be informed if there is not adequate staff present to maintain the required ratios. 2. We discuss continuing to utilize substitution companies to help with staffing when an immediate need arises. 3. It was recommended to review the daily schedules for the two existing staff and begin working to get your husband qualified as a substitute caregiver for an emergency. 4. We reviewed the child care supervision rule and staff to child ratio child care rules: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. History Note: Authority G.S. 110-85; 110-91(7); 143B-168.3; 5. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 6. We discussed based on the substantiation; an administrative action would be required based on DCDEE procedures. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Monday, February 26, 2024. You may email me your letter of correction. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report 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 .2818 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: 0224-076L Visit Date: 2/12/2024 Number Present: 11 Completed Date: 2/12/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:30 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate allegations of violations of child care requirements. Upon arrival I was greeted at the front door by Ms. Miller. Ms. Miller was observed with six children present, ranging in age from six months to two years of age in space #1. Ms. Joy was in space #2 with four children, ranging in age two years to four years of age. Two additional preschool children arrived shortly thereafter. The following allegations were read aloud to Ms. Parks: There is a concern that the center is out of ratios during the morning. Ms. Parks stated a child was sent to just wash his hands. I asked isn’t there a bathroom directly located off of space #2? Ms. Parks stated she was in the bathroom. Child care Rule. 0713(b) was reviewed with Ms. Parks. Daily sign in and out were monitored to discern average arrival times of children. Ms. Parks stated some issues with staffing over the last couple of weeks. A substitute was in place but didn’t show up to work and has not heard from her since. The majority of children arrive between 8:00 am and 9:00 am daily. There were arrival times where seven children were on site by 9:00 am. I inquired about utilizing her husband who is visually impaired. I reviewed the supervision child care rule with Ms. Parks, and we discussed how he could be used to help provide substitute care if a staff person is late or calls out due to illness or circumstances. Currently, Mr. Parks only meets the qualifications of a household member. We also discussed altering the other lead teacher’s daily schedule. A substitute file checklist was emailed to Ms. Parks during the visit. Three staff, including Ms. Parks, were interviewed. Staff stated there were times when Ms. Parks was present in space #1 with seven children present ranging in age from six months to two years of age. Based on my observations and discussions with three staff the allegation of the center being out of ratio during the morning was SUBSTANTIATED. Today, there were six children located in space #1 with one caregiver. The youngest age of the child present was six months. The required ratio was 1:5. Two children were relocated to space #2 to rectify the staff to child ratio violation. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. Upon arrival, there were six children with one caregiver located in space #1. The children ranged in age from six months to two years of age. Two, two-year-old children were relocated to space #2. 10A NCAC 09 .2818 Technical Assistance Provided and General Discussion: 1. It was recommended to develop a communication policy or process to communicate with families in the mornings if a staffing issue arises and there is not adequate staff to maintain the required staff to child ratios. Families should be informed if there is not adequate staff present to maintain the required ratios. 2. We discuss continuing to utilize substitution companies to help with staffing when an immediate need arises. 3. It was recommended to review the daily schedules for the two existing staff and begin working to get your husband qualified as a substitute caregiver for an emergency. 4. We reviewed the child care supervision rule and staff to child ratio child care rules: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. History Note: Authority G.S. 110-85; 110-91(7); 143B-168.3; 5. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 6. We discussed based on the substantiation; an administrative action would be required based on DCDEE procedures. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Monday, February 26, 2024. You may email me your letter of correction. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report 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. 110-85 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: 0224-076L Visit Date: 2/12/2024 Number Present: 11 Completed Date: 2/12/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:30 AM Time Out: 12:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate allegations of violations of child care requirements. Upon arrival I was greeted at the front door by Ms. Miller. Ms. Miller was observed with six children present, ranging in age from six months to two years of age in space #1. Ms. Joy was in space #2 with four children, ranging in age two years to four years of age. Two additional preschool children arrived shortly thereafter. The following allegations were read aloud to Ms. Parks: There is a concern that the center is out of ratios during the morning. Ms. Parks stated a child was sent to just wash his hands. I asked isn’t there a bathroom directly located off of space #2? Ms. Parks stated she was in the bathroom. Child care Rule. 0713(b) was reviewed with Ms. Parks. Daily sign in and out were monitored to discern average arrival times of children. Ms. Parks stated some issues with staffing over the last couple of weeks. A substitute was in place but didn’t show up to work and has not heard from her since. The majority of children arrive between 8:00 am and 9:00 am daily. There were arrival times where seven children were on site by 9:00 am. I inquired about utilizing her husband who is visually impaired. I reviewed the supervision child care rule with Ms. Parks, and we discussed how he could be used to help provide substitute care if a staff person is late or calls out due to illness or circumstances. Currently, Mr. Parks only meets the qualifications of a household member. We also discussed altering the other lead teacher’s daily schedule. A substitute file checklist was emailed to Ms. Parks during the visit. Three staff, including Ms. Parks, were interviewed. Staff stated there were times when Ms. Parks was present in space #1 with seven children present ranging in age from six months to two years of age. Based on my observations and discussions with three staff the allegation of the center being out of ratio during the morning was SUBSTANTIATED. Today, there were six children located in space #1 with one caregiver. The youngest age of the child present was six months. The required ratio was 1:5. Two children were relocated to space #2 to rectify the staff to child ratio violation. Violation Number Comment Rule 1756 Enhanced staff/child ratios and group sizes were not met. Upon arrival, there were six children with one caregiver located in space #1. The children ranged in age from six months to two years of age. Two, two-year-old children were relocated to space #2. 10A NCAC 09 .2818 Technical Assistance Provided and General Discussion: 1. It was recommended to develop a communication policy or process to communicate with families in the mornings if a staffing issue arises and there is not adequate staff to maintain the required staff to child ratios. Families should be informed if there is not adequate staff present to maintain the required ratios. 2. We discuss continuing to utilize substitution companies to help with staffing when an immediate need arises. 3. It was recommended to review the daily schedules for the two existing staff and begin working to get your husband qualified as a substitute caregiver for an emergency. 4. We reviewed the child care supervision rule and staff to child ratio child care rules: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. (b) For groups of children aged two years or older, the staff/child ratio during nap time shall comply with the requirements of this Chapter if at least one person remains in the room, all children are visible to that person, and the total number of required staff are on the premises and within calling distance of the rooms occupied by children. History Note: Authority G.S. 110-85; 110-91(7); 143B-168.3; 5. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 6. We discussed based on the substantiation; an administrative action would be required based on DCDEE procedures. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Monday, February 26, 2024. You may email me your letter of correction. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report 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: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 12 Completed Date: 1/16/2024 Age: From 0 To 4 Total Minutes: 270 Time In: 10:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during the Annual Compliance Visit. Upon arrival at the five-star rated Center Located within A Residence, I was greeted by one of the lead teachers/operator Mrs. Joy Parks. The center maintains a five-star rated license and continues to meet enhanced space and ratios. The Annual Compliance Monitoring Checklist for Child Care Centers and the Child Care Item Number Listing dated August 2023 were used to document compliance. Spaces #1-2, two outdoor learning environments and kitchen were monitored for compliance. The Regulatory system was verified. The operator was previously approved to transport children. The transportation field was removed from the operating license in the system. If the center changes their mind and would like to be approved again to transport children, the licensing consultant must be contacted before transportation resumes. Licensing requirements related to transportation would need to be monitored to ensure licensing requirements were met before children are transported. Children were monitored diapering, drinking a sippy cup, napping on cots with linen. Two children’s files were monitored for compliance. Two children did not have current annual permission for off premises activities. One child did not have a current medical action plan on file. and found to meet child care requirements. Children did not have a current annual permission to play outside of the fenced area. One child did not have written permission to administer a prescribed life altering medication. The permission slip must be renewed every six months. The DCDEE permission slip and log were emailed to Mrs. Joy after the visit. The center implemented the Mother Goose Curriculum with four-year-old children. Mrs. Parks also indicated incorporating two other curriculums in the center with the younger children. Staff and Training worksheets were monitored not current. I asked Mrs. Joy to update the worksheets and email them to me by the next morning. Items were monitored current during the visit. We discussed adding the practicum student to a separately tracked staff and training worksheet going forward. Existing staff files were monitored for compliance during the visit. We reviewed each staff person’s date of hire date and annual due date for each staff to obtain their annual in-service training hours. The center’s EPR plan was monitored for compliance and was current. The current consultant’s contact information and name should be updated before the annual expiration in 2024. The EPR RTGF was monitored not current. Blank incident reports, an area map and children’s allergy list were not maintained in the required file. A checklist was emailed to Mrs. Joy to help ensure all required components were maintained. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The last sanitation inspection was conducted July 12, 2023, with four (4) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on February 1, 2023. It was highly recommended to begin the annual inspection process immediately. The center continues to meet five-star requirements and a three-year reassessment will be required no later than July 11, 2025. The last ERS were completed September 23, 2019. The RLA packet was processed October 2, 2019. The overall average ERS was 5.66. Based on the DCDEE Cohort Plans for reassessments, the program is in Cohort Plan #2. Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. A prescription of Diastat was monitored with an expiration date of 10/2026 listed on the medication. The prescription label listed on the same box of medicine stated to discard after 6/4/2023. .0803(2)(a) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. There was not annual written parental permission on file for children to participate in off premise activities. .1005(b)(4) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File was not current with required children's medical action plans, blank incident report forms, center allergy list, children's nutritional information. .0607(d)(10) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One child's medical action plan was not current. It was monitored dated 2022. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was not current parental permission to administer prescribed medications for chronic medical conditions (required every six months). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. It was recommended to use the DCDEE child checklist to ensure all required documents are updated annually. The checklist lists what is required and by when. I recommended highlighting the documents listed in the checklist that require annual updating. 2. It was recommended to leave the EPR/RTGF Checklist in the binder used to maintain the required records. Leaving the checklist inside of the binder will ensure all required items are maintained in the file. 3. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 4. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; (b) if pharmaceutical samples, shall be stored in the manufacturer's original packaging, shall be labeled with the child's name, and shall be accompanied by written instructions specifying: (i) the child's name; (ii) the names of the medication; (iii) the amount and frequency of dosage; (iv) the signature of the prescribing physician or other health professional; and (v) the date the instructions were signed by the physician or other health professional; (c) shall be administered only to the child for whom they were prescribed; and (d) shall be administered according to the prescription, using amount and frequency of dosage specified on the label. (3) A parent's written authorization for the administration of a prescription medication described in Item (2) of this Rule shall be valid for the length of time the medication is prescribed to be taken. (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. (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. (8) A parent may give a caregiver standing authorization to administer a single weight-appropriate dose of acetaminophen to a child in the event the child has a fever and a parent cannot be reached. The authorization shall be in writing 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. (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. (10) Pursuant to G.S. 110-102.1A, a caregiver may administer medication to a child without parental authorization in the event of an emergency medical condition when the child's parent is unavailable, and providing the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider. (11) A parent may withdraw written authorization for the administration of medications at any time in writing. (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. (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. (14) If medication is administered in error, whether administering the wrong dosage, giving to the wrong child, or giving the incorrect type of medicine, the child care center shall: (a) call 911 in accordance with CPR or First Aid training recommendations; (b) notify the center director; (c) contact the child's parent; (d) observe the child; and (e) document the medication error in writing, including: (i) the child's name and date of birth; (ii) the type and dosage of medication administered; (iii) the name of the person who administered the medication; (iv) the date and time of the error; (v) the signature of the child care administrator, the parent and the staff member who administered the medication; (vi) the actions taken by the center following the error; and (vii) the actions that will be taken by the center to prevent a future error. This documentation shall be maintained in the child's file. History Note: Authority G.S. 110-85; 110-91(1),(9); 110-102.1A; 143B-168.3; 5. The groupings of children in the CLAIR were discussed and reviewed to ensure compliance. The CLAIR operates two separate spaces (#1 and #2). The following child care rules were emailed and shared with Mrs. Parks after the visit and further consultation with the previous consultant and licensing supervisor. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children Ratio Staff/Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 (c) The staff/child ratio applicable to a classroom for a center located in a residence as described in Paragraph (b) of this Rule shall be posted in that classroom in an area that parents are able to view at all times. (d) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. (e) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule the operator shall select one of the following options for emergency relief: (1) the center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or (2) there shall be a second adult on the premises who is available to provide emergency relief. 6. It was recommended to use a zip lock bag and sharpie pen to label the expiration dates for medication, prescription, and six-month permission slips for chronic medical conditions. 7. The EPR RTGF checklist and child care rules related to medications, grouping of children in CLAIR facilities, staff annual in-service hours due dates, and health and safety requirements were discussed and reviewed. 8. It was recommended to contact the Community Health Nurses to inquire if any support could be provided related to life altering medications, child care rules and best practices. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Tuesday, January 30, 2023. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0801 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 12 Completed Date: 1/16/2024 Age: From 0 To 4 Total Minutes: 270 Time In: 10:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during the Annual Compliance Visit. Upon arrival at the five-star rated Center Located within A Residence, I was greeted by one of the lead teachers/operator Mrs. Joy Parks. The center maintains a five-star rated license and continues to meet enhanced space and ratios. The Annual Compliance Monitoring Checklist for Child Care Centers and the Child Care Item Number Listing dated August 2023 were used to document compliance. Spaces #1-2, two outdoor learning environments and kitchen were monitored for compliance. The Regulatory system was verified. The operator was previously approved to transport children. The transportation field was removed from the operating license in the system. If the center changes their mind and would like to be approved again to transport children, the licensing consultant must be contacted before transportation resumes. Licensing requirements related to transportation would need to be monitored to ensure licensing requirements were met before children are transported. Children were monitored diapering, drinking a sippy cup, napping on cots with linen. Two children’s files were monitored for compliance. Two children did not have current annual permission for off premises activities. One child did not have a current medical action plan on file. and found to meet child care requirements. Children did not have a current annual permission to play outside of the fenced area. One child did not have written permission to administer a prescribed life altering medication. The permission slip must be renewed every six months. The DCDEE permission slip and log were emailed to Mrs. Joy after the visit. The center implemented the Mother Goose Curriculum with four-year-old children. Mrs. Parks also indicated incorporating two other curriculums in the center with the younger children. Staff and Training worksheets were monitored not current. I asked Mrs. Joy to update the worksheets and email them to me by the next morning. Items were monitored current during the visit. We discussed adding the practicum student to a separately tracked staff and training worksheet going forward. Existing staff files were monitored for compliance during the visit. We reviewed each staff person’s date of hire date and annual due date for each staff to obtain their annual in-service training hours. The center’s EPR plan was monitored for compliance and was current. The current consultant’s contact information and name should be updated before the annual expiration in 2024. The EPR RTGF was monitored not current. Blank incident reports, an area map and children’s allergy list were not maintained in the required file. A checklist was emailed to Mrs. Joy to help ensure all required components were maintained. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The last sanitation inspection was conducted July 12, 2023, with four (4) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on February 1, 2023. It was highly recommended to begin the annual inspection process immediately. The center continues to meet five-star requirements and a three-year reassessment will be required no later than July 11, 2025. The last ERS were completed September 23, 2019. The RLA packet was processed October 2, 2019. The overall average ERS was 5.66. Based on the DCDEE Cohort Plans for reassessments, the program is in Cohort Plan #2. Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. A prescription of Diastat was monitored with an expiration date of 10/2026 listed on the medication. The prescription label listed on the same box of medicine stated to discard after 6/4/2023. .0803(2)(a) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. There was not annual written parental permission on file for children to participate in off premise activities. .1005(b)(4) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File was not current with required children's medical action plans, blank incident report forms, center allergy list, children's nutritional information. .0607(d)(10) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One child's medical action plan was not current. It was monitored dated 2022. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was not current parental permission to administer prescribed medications for chronic medical conditions (required every six months). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. It was recommended to use the DCDEE child checklist to ensure all required documents are updated annually. The checklist lists what is required and by when. I recommended highlighting the documents listed in the checklist that require annual updating. 2. It was recommended to leave the EPR/RTGF Checklist in the binder used to maintain the required records. Leaving the checklist inside of the binder will ensure all required items are maintained in the file. 3. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 4. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; (b) if pharmaceutical samples, shall be stored in the manufacturer's original packaging, shall be labeled with the child's name, and shall be accompanied by written instructions specifying: (i) the child's name; (ii) the names of the medication; (iii) the amount and frequency of dosage; (iv) the signature of the prescribing physician or other health professional; and (v) the date the instructions were signed by the physician or other health professional; (c) shall be administered only to the child for whom they were prescribed; and (d) shall be administered according to the prescription, using amount and frequency of dosage specified on the label. (3) A parent's written authorization for the administration of a prescription medication described in Item (2) of this Rule shall be valid for the length of time the medication is prescribed to be taken. (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. (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. (8) A parent may give a caregiver standing authorization to administer a single weight-appropriate dose of acetaminophen to a child in the event the child has a fever and a parent cannot be reached. The authorization shall be in writing 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. (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. (10) Pursuant to G.S. 110-102.1A, a caregiver may administer medication to a child without parental authorization in the event of an emergency medical condition when the child's parent is unavailable, and providing the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider. (11) A parent may withdraw written authorization for the administration of medications at any time in writing. (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. (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. (14) If medication is administered in error, whether administering the wrong dosage, giving to the wrong child, or giving the incorrect type of medicine, the child care center shall: (a) call 911 in accordance with CPR or First Aid training recommendations; (b) notify the center director; (c) contact the child's parent; (d) observe the child; and (e) document the medication error in writing, including: (i) the child's name and date of birth; (ii) the type and dosage of medication administered; (iii) the name of the person who administered the medication; (iv) the date and time of the error; (v) the signature of the child care administrator, the parent and the staff member who administered the medication; (vi) the actions taken by the center following the error; and (vii) the actions that will be taken by the center to prevent a future error. This documentation shall be maintained in the child's file. History Note: Authority G.S. 110-85; 110-91(1),(9); 110-102.1A; 143B-168.3; 5. The groupings of children in the CLAIR were discussed and reviewed to ensure compliance. The CLAIR operates two separate spaces (#1 and #2). The following child care rules were emailed and shared with Mrs. Parks after the visit and further consultation with the previous consultant and licensing supervisor. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children Ratio Staff/Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 (c) The staff/child ratio applicable to a classroom for a center located in a residence as described in Paragraph (b) of this Rule shall be posted in that classroom in an area that parents are able to view at all times. (d) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. (e) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule the operator shall select one of the following options for emergency relief: (1) the center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or (2) there shall be a second adult on the premises who is available to provide emergency relief. 6. It was recommended to use a zip lock bag and sharpie pen to label the expiration dates for medication, prescription, and six-month permission slips for chronic medical conditions. 7. The EPR RTGF checklist and child care rules related to medications, grouping of children in CLAIR facilities, staff annual in-service hours due dates, and health and safety requirements were discussed and reviewed. 8. It was recommended to contact the Community Health Nurses to inquire if any support could be provided related to life altering medications, child care rules and best practices. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Tuesday, January 30, 2023. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report 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: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 12 Completed Date: 1/16/2024 Age: From 0 To 4 Total Minutes: 270 Time In: 10:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during the Annual Compliance Visit. Upon arrival at the five-star rated Center Located within A Residence, I was greeted by one of the lead teachers/operator Mrs. Joy Parks. The center maintains a five-star rated license and continues to meet enhanced space and ratios. The Annual Compliance Monitoring Checklist for Child Care Centers and the Child Care Item Number Listing dated August 2023 were used to document compliance. Spaces #1-2, two outdoor learning environments and kitchen were monitored for compliance. The Regulatory system was verified. The operator was previously approved to transport children. The transportation field was removed from the operating license in the system. If the center changes their mind and would like to be approved again to transport children, the licensing consultant must be contacted before transportation resumes. Licensing requirements related to transportation would need to be monitored to ensure licensing requirements were met before children are transported. Children were monitored diapering, drinking a sippy cup, napping on cots with linen. Two children’s files were monitored for compliance. Two children did not have current annual permission for off premises activities. One child did not have a current medical action plan on file. and found to meet child care requirements. Children did not have a current annual permission to play outside of the fenced area. One child did not have written permission to administer a prescribed life altering medication. The permission slip must be renewed every six months. The DCDEE permission slip and log were emailed to Mrs. Joy after the visit. The center implemented the Mother Goose Curriculum with four-year-old children. Mrs. Parks also indicated incorporating two other curriculums in the center with the younger children. Staff and Training worksheets were monitored not current. I asked Mrs. Joy to update the worksheets and email them to me by the next morning. Items were monitored current during the visit. We discussed adding the practicum student to a separately tracked staff and training worksheet going forward. Existing staff files were monitored for compliance during the visit. We reviewed each staff person’s date of hire date and annual due date for each staff to obtain their annual in-service training hours. The center’s EPR plan was monitored for compliance and was current. The current consultant’s contact information and name should be updated before the annual expiration in 2024. The EPR RTGF was monitored not current. Blank incident reports, an area map and children’s allergy list were not maintained in the required file. A checklist was emailed to Mrs. Joy to help ensure all required components were maintained. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The last sanitation inspection was conducted July 12, 2023, with four (4) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on February 1, 2023. It was highly recommended to begin the annual inspection process immediately. The center continues to meet five-star requirements and a three-year reassessment will be required no later than July 11, 2025. The last ERS were completed September 23, 2019. The RLA packet was processed October 2, 2019. The overall average ERS was 5.66. Based on the DCDEE Cohort Plans for reassessments, the program is in Cohort Plan #2. Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. A prescription of Diastat was monitored with an expiration date of 10/2026 listed on the medication. The prescription label listed on the same box of medicine stated to discard after 6/4/2023. .0803(2)(a) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. There was not annual written parental permission on file for children to participate in off premise activities. .1005(b)(4) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File was not current with required children's medical action plans, blank incident report forms, center allergy list, children's nutritional information. .0607(d)(10) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One child's medical action plan was not current. It was monitored dated 2022. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was not current parental permission to administer prescribed medications for chronic medical conditions (required every six months). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. It was recommended to use the DCDEE child checklist to ensure all required documents are updated annually. The checklist lists what is required and by when. I recommended highlighting the documents listed in the checklist that require annual updating. 2. It was recommended to leave the EPR/RTGF Checklist in the binder used to maintain the required records. Leaving the checklist inside of the binder will ensure all required items are maintained in the file. 3. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 4. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; (b) if pharmaceutical samples, shall be stored in the manufacturer's original packaging, shall be labeled with the child's name, and shall be accompanied by written instructions specifying: (i) the child's name; (ii) the names of the medication; (iii) the amount and frequency of dosage; (iv) the signature of the prescribing physician or other health professional; and (v) the date the instructions were signed by the physician or other health professional; (c) shall be administered only to the child for whom they were prescribed; and (d) shall be administered according to the prescription, using amount and frequency of dosage specified on the label. (3) A parent's written authorization for the administration of a prescription medication described in Item (2) of this Rule shall be valid for the length of time the medication is prescribed to be taken. (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. (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. (8) A parent may give a caregiver standing authorization to administer a single weight-appropriate dose of acetaminophen to a child in the event the child has a fever and a parent cannot be reached. The authorization shall be in writing 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. (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. (10) Pursuant to G.S. 110-102.1A, a caregiver may administer medication to a child without parental authorization in the event of an emergency medical condition when the child's parent is unavailable, and providing the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider. (11) A parent may withdraw written authorization for the administration of medications at any time in writing. (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. (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. (14) If medication is administered in error, whether administering the wrong dosage, giving to the wrong child, or giving the incorrect type of medicine, the child care center shall: (a) call 911 in accordance with CPR or First Aid training recommendations; (b) notify the center director; (c) contact the child's parent; (d) observe the child; and (e) document the medication error in writing, including: (i) the child's name and date of birth; (ii) the type and dosage of medication administered; (iii) the name of the person who administered the medication; (iv) the date and time of the error; (v) the signature of the child care administrator, the parent and the staff member who administered the medication; (vi) the actions taken by the center following the error; and (vii) the actions that will be taken by the center to prevent a future error. This documentation shall be maintained in the child's file. History Note: Authority G.S. 110-85; 110-91(1),(9); 110-102.1A; 143B-168.3; 5. The groupings of children in the CLAIR were discussed and reviewed to ensure compliance. The CLAIR operates two separate spaces (#1 and #2). The following child care rules were emailed and shared with Mrs. Parks after the visit and further consultation with the previous consultant and licensing supervisor. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children Ratio Staff/Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 (c) The staff/child ratio applicable to a classroom for a center located in a residence as described in Paragraph (b) of this Rule shall be posted in that classroom in an area that parents are able to view at all times. (d) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. (e) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule the operator shall select one of the following options for emergency relief: (1) the center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or (2) there shall be a second adult on the premises who is available to provide emergency relief. 6. It was recommended to use a zip lock bag and sharpie pen to label the expiration dates for medication, prescription, and six-month permission slips for chronic medical conditions. 7. The EPR RTGF checklist and child care rules related to medications, grouping of children in CLAIR facilities, staff annual in-service hours due dates, and health and safety requirements were discussed and reviewed. 8. It was recommended to contact the Community Health Nurses to inquire if any support could be provided related to life altering medications, child care rules and best practices. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Tuesday, January 30, 2023. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report 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. 110-102 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 12 Completed Date: 1/16/2024 Age: From 0 To 4 Total Minutes: 270 Time In: 10:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during the Annual Compliance Visit. Upon arrival at the five-star rated Center Located within A Residence, I was greeted by one of the lead teachers/operator Mrs. Joy Parks. The center maintains a five-star rated license and continues to meet enhanced space and ratios. The Annual Compliance Monitoring Checklist for Child Care Centers and the Child Care Item Number Listing dated August 2023 were used to document compliance. Spaces #1-2, two outdoor learning environments and kitchen were monitored for compliance. The Regulatory system was verified. The operator was previously approved to transport children. The transportation field was removed from the operating license in the system. If the center changes their mind and would like to be approved again to transport children, the licensing consultant must be contacted before transportation resumes. Licensing requirements related to transportation would need to be monitored to ensure licensing requirements were met before children are transported. Children were monitored diapering, drinking a sippy cup, napping on cots with linen. Two children’s files were monitored for compliance. Two children did not have current annual permission for off premises activities. One child did not have a current medical action plan on file. and found to meet child care requirements. Children did not have a current annual permission to play outside of the fenced area. One child did not have written permission to administer a prescribed life altering medication. The permission slip must be renewed every six months. The DCDEE permission slip and log were emailed to Mrs. Joy after the visit. The center implemented the Mother Goose Curriculum with four-year-old children. Mrs. Parks also indicated incorporating two other curriculums in the center with the younger children. Staff and Training worksheets were monitored not current. I asked Mrs. Joy to update the worksheets and email them to me by the next morning. Items were monitored current during the visit. We discussed adding the practicum student to a separately tracked staff and training worksheet going forward. Existing staff files were monitored for compliance during the visit. We reviewed each staff person’s date of hire date and annual due date for each staff to obtain their annual in-service training hours. The center’s EPR plan was monitored for compliance and was current. The current consultant’s contact information and name should be updated before the annual expiration in 2024. The EPR RTGF was monitored not current. Blank incident reports, an area map and children’s allergy list were not maintained in the required file. A checklist was emailed to Mrs. Joy to help ensure all required components were maintained. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The last sanitation inspection was conducted July 12, 2023, with four (4) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on February 1, 2023. It was highly recommended to begin the annual inspection process immediately. The center continues to meet five-star requirements and a three-year reassessment will be required no later than July 11, 2025. The last ERS were completed September 23, 2019. The RLA packet was processed October 2, 2019. The overall average ERS was 5.66. Based on the DCDEE Cohort Plans for reassessments, the program is in Cohort Plan #2. Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. A prescription of Diastat was monitored with an expiration date of 10/2026 listed on the medication. The prescription label listed on the same box of medicine stated to discard after 6/4/2023. .0803(2)(a) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. There was not annual written parental permission on file for children to participate in off premise activities. .1005(b)(4) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File was not current with required children's medical action plans, blank incident report forms, center allergy list, children's nutritional information. .0607(d)(10) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One child's medical action plan was not current. It was monitored dated 2022. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was not current parental permission to administer prescribed medications for chronic medical conditions (required every six months). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. It was recommended to use the DCDEE child checklist to ensure all required documents are updated annually. The checklist lists what is required and by when. I recommended highlighting the documents listed in the checklist that require annual updating. 2. It was recommended to leave the EPR/RTGF Checklist in the binder used to maintain the required records. Leaving the checklist inside of the binder will ensure all required items are maintained in the file. 3. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 4. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; (b) if pharmaceutical samples, shall be stored in the manufacturer's original packaging, shall be labeled with the child's name, and shall be accompanied by written instructions specifying: (i) the child's name; (ii) the names of the medication; (iii) the amount and frequency of dosage; (iv) the signature of the prescribing physician or other health professional; and (v) the date the instructions were signed by the physician or other health professional; (c) shall be administered only to the child for whom they were prescribed; and (d) shall be administered according to the prescription, using amount and frequency of dosage specified on the label. (3) A parent's written authorization for the administration of a prescription medication described in Item (2) of this Rule shall be valid for the length of time the medication is prescribed to be taken. (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. (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. (8) A parent may give a caregiver standing authorization to administer a single weight-appropriate dose of acetaminophen to a child in the event the child has a fever and a parent cannot be reached. The authorization shall be in writing 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. (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. (10) Pursuant to G.S. 110-102.1A, a caregiver may administer medication to a child without parental authorization in the event of an emergency medical condition when the child's parent is unavailable, and providing the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider. (11) A parent may withdraw written authorization for the administration of medications at any time in writing. (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. (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. (14) If medication is administered in error, whether administering the wrong dosage, giving to the wrong child, or giving the incorrect type of medicine, the child care center shall: (a) call 911 in accordance with CPR or First Aid training recommendations; (b) notify the center director; (c) contact the child's parent; (d) observe the child; and (e) document the medication error in writing, including: (i) the child's name and date of birth; (ii) the type and dosage of medication administered; (iii) the name of the person who administered the medication; (iv) the date and time of the error; (v) the signature of the child care administrator, the parent and the staff member who administered the medication; (vi) the actions taken by the center following the error; and (vii) the actions that will be taken by the center to prevent a future error. This documentation shall be maintained in the child's file. History Note: Authority G.S. 110-85; 110-91(1),(9); 110-102.1A; 143B-168.3; 5. The groupings of children in the CLAIR were discussed and reviewed to ensure compliance. The CLAIR operates two separate spaces (#1 and #2). The following child care rules were emailed and shared with Mrs. Parks after the visit and further consultation with the previous consultant and licensing supervisor. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children Ratio Staff/Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 (c) The staff/child ratio applicable to a classroom for a center located in a residence as described in Paragraph (b) of this Rule shall be posted in that classroom in an area that parents are able to view at all times. (d) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. (e) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule the operator shall select one of the following options for emergency relief: (1) the center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or (2) there shall be a second adult on the premises who is available to provide emergency relief. 6. It was recommended to use a zip lock bag and sharpie pen to label the expiration dates for medication, prescription, and six-month permission slips for chronic medical conditions. 7. The EPR RTGF checklist and child care rules related to medications, grouping of children in CLAIR facilities, staff annual in-service hours due dates, and health and safety requirements were discussed and reviewed. 8. It was recommended to contact the Community Health Nurses to inquire if any support could be provided related to life altering medications, child care rules and best practices. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Tuesday, January 30, 2023. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report 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. 110-85 · Violation

Name of Operation: JOYLAND ACADEMY Facility ID: 60002477 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 12 Completed Date: 1/16/2024 Age: From 0 To 4 Total Minutes: 270 Time In: 10:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during the Annual Compliance Visit. Upon arrival at the five-star rated Center Located within A Residence, I was greeted by one of the lead teachers/operator Mrs. Joy Parks. The center maintains a five-star rated license and continues to meet enhanced space and ratios. The Annual Compliance Monitoring Checklist for Child Care Centers and the Child Care Item Number Listing dated August 2023 were used to document compliance. Spaces #1-2, two outdoor learning environments and kitchen were monitored for compliance. The Regulatory system was verified. The operator was previously approved to transport children. The transportation field was removed from the operating license in the system. If the center changes their mind and would like to be approved again to transport children, the licensing consultant must be contacted before transportation resumes. Licensing requirements related to transportation would need to be monitored to ensure licensing requirements were met before children are transported. Children were monitored diapering, drinking a sippy cup, napping on cots with linen. Two children’s files were monitored for compliance. Two children did not have current annual permission for off premises activities. One child did not have a current medical action plan on file. and found to meet child care requirements. Children did not have a current annual permission to play outside of the fenced area. One child did not have written permission to administer a prescribed life altering medication. The permission slip must be renewed every six months. The DCDEE permission slip and log were emailed to Mrs. Joy after the visit. The center implemented the Mother Goose Curriculum with four-year-old children. Mrs. Parks also indicated incorporating two other curriculums in the center with the younger children. Staff and Training worksheets were monitored not current. I asked Mrs. Joy to update the worksheets and email them to me by the next morning. Items were monitored current during the visit. We discussed adding the practicum student to a separately tracked staff and training worksheet going forward. Existing staff files were monitored for compliance during the visit. We reviewed each staff person’s date of hire date and annual due date for each staff to obtain their annual in-service training hours. The center’s EPR plan was monitored for compliance and was current. The current consultant’s contact information and name should be updated before the annual expiration in 2024. The EPR RTGF was monitored not current. Blank incident reports, an area map and children’s allergy list were not maintained in the required file. A checklist was emailed to Mrs. Joy to help ensure all required components were maintained. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The last sanitation inspection was conducted July 12, 2023, with four (4) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on February 1, 2023. It was highly recommended to begin the annual inspection process immediately. The center continues to meet five-star requirements and a three-year reassessment will be required no later than July 11, 2025. The last ERS were completed September 23, 2019. The RLA packet was processed October 2, 2019. The overall average ERS was 5.66. Based on the DCDEE Cohort Plans for reassessments, the program is in Cohort Plan #2. Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. A prescription of Diastat was monitored with an expiration date of 10/2026 listed on the medication. The prescription label listed on the same box of medicine stated to discard after 6/4/2023. .0803(2)(a) 1322 A written statement from each child's parent giving standing permission which may be valid for up to twelve months for participation in off premise activities that occur on a regular basis was not available. There was not annual written parental permission on file for children to participate in off premise activities. .1005(b)(4) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File was not current with required children's medical action plans, blank incident report forms, center allergy list, children's nutritional information. .0607(d)(10) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. One child's medical action plan was not current. It was monitored dated 2022. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was not current parental permission to administer prescribed medications for chronic medical conditions (required every six months). .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. It was recommended to use the DCDEE child checklist to ensure all required documents are updated annually. The checklist lists what is required and by when. I recommended highlighting the documents listed in the checklist that require annual updating. 2. It was recommended to leave the EPR/RTGF Checklist in the binder used to maintain the required records. Leaving the checklist inside of the binder will ensure all required items are maintained in the file. 3. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; 4. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; (b) if pharmaceutical samples, shall be stored in the manufacturer's original packaging, shall be labeled with the child's name, and shall be accompanied by written instructions specifying: (i) the child's name; (ii) the names of the medication; (iii) the amount and frequency of dosage; (iv) the signature of the prescribing physician or other health professional; and (v) the date the instructions were signed by the physician or other health professional; (c) shall be administered only to the child for whom they were prescribed; and (d) shall be administered according to the prescription, using amount and frequency of dosage specified on the label. (3) A parent's written authorization for the administration of a prescription medication described in Item (2) of this Rule shall be valid for the length of time the medication is prescribed to be taken. (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. (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. (8) A parent may give a caregiver standing authorization to administer a single weight-appropriate dose of acetaminophen to a child in the event the child has a fever and a parent cannot be reached. The authorization shall be in writing 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. (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. (10) Pursuant to G.S. 110-102.1A, a caregiver may administer medication to a child without parental authorization in the event of an emergency medical condition when the child's parent is unavailable, and providing the medication is administered with the authorization and in accordance with instructions from a bona fide medical care provider. (11) A parent may withdraw written authorization for the administration of medications at any time in writing. (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. (13) Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. No documentation shall be required when items listed in Item (7) of this Rule are applied to children. (14) If medication is administered in error, whether administering the wrong dosage, giving to the wrong child, or giving the incorrect type of medicine, the child care center shall: (a) call 911 in accordance with CPR or First Aid training recommendations; (b) notify the center director; (c) contact the child's parent; (d) observe the child; and (e) document the medication error in writing, including: (i) the child's name and date of birth; (ii) the type and dosage of medication administered; (iii) the name of the person who administered the medication; (iv) the date and time of the error; (v) the signature of the child care administrator, the parent and the staff member who administered the medication; (vi) the actions taken by the center following the error; and (vii) the actions that will be taken by the center to prevent a future error. This documentation shall be maintained in the child's file. History Note: Authority G.S. 110-85; 110-91(1),(9); 110-102.1A; 143B-168.3; 5. The groupings of children in the CLAIR were discussed and reviewed to ensure compliance. The CLAIR operates two separate spaces (#1 and #2). The following child care rules were emailed and shared with Mrs. Parks after the visit and further consultation with the previous consultant and licensing supervisor. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (b) The staff/child ratios for a center located in a residence with a licensed capacity of 3 to 12 children when any preschool-age child is enrolled, or with a licensed capacity of 3 to 15 children when only school-age children are enrolled, are as follows: Age of Children Ratio Staff/Children 0 to 12 Months 1/5 preschool children plus three additional school-age children 12 to 24 Months 1/6 preschool children plus two additional school-age children 2 to 13 Years 1/10 3 to 13 Years 1/12 All school-age 1/15 (c) The staff/child ratio applicable to a classroom for a center located in a residence as described in Paragraph (b) of this Rule shall be posted in that classroom in an area that parents are able to view at all times. (d) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. (e) When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as described in Paragraph (b) of this Rule the operator shall select one of the following options for emergency relief: (1) the center shall post the name, address, and telephone number of an adult who has agreed in writing to be available to provide emergency relief and who can respond within a reasonable period of time; or (2) there shall be a second adult on the premises who is available to provide emergency relief. 6. It was recommended to use a zip lock bag and sharpie pen to label the expiration dates for medication, prescription, and six-month permission slips for chronic medical conditions. 7. The EPR RTGF checklist and child care rules related to medications, grouping of children in CLAIR facilities, staff annual in-service hours due dates, and health and safety requirements were discussed and reviewed. 8. It was recommended to contact the Community Health Nurses to inquire if any support could be provided related to life altering medications, child care rules and best practices. Corrective Action Plan: All violations must be corrected immediately. You shall submit a written, signed, and dated statement/compliance letter to me, at the address below detailing how each violation has been corrected and when. This information shall be received by Tuesday, January 30, 2023. Mail written documentation to Mara Brinton, 7870 Woodmere Drive, Harrisburg, NC 28075. 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 or an administrative action may be recommended. 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. If you have any questions, please contact Mara Brinton at 704-594-0140 or email mara.brinton@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times