GS 110-91 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 11/12/2024 Number Present: 56 Completed Date: 11/12/2024 Age: From 2 To 5 Total Minutes: 205 Time In: 09:35 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor for compliance with applicable child care requirements during a Routine Unannounced Visit. Michele Sullivan, Licensing Supervisor accompanied me during the visit. Upon arrival at the five-star rated licensed center, the center’s administrator, Ms. Elizabeth Carson, was retrieved by the family services coordinator. The child care item number listing dated March 2024 was used to identify and determine non-compliance. The following sections were monitored for compliance: A1, B1, C4, C5, C6, E1, E2, F3, G1, G3, G4 and G5. A walk through of spaces #1-6, the kitchen and outdoor area were monitored for compliance. The center’s bus was off-site attending a field trip with one class. A field trip notice with required information was posted on the applicable door. Monthly outdoor inspections, incident log, monthly fire drills and quarterly safety drills were monitored. Technical assistance was provided regarding rule requirements related to where a completed incident report was required to be filed. The posted menu in the hallway was dated and current. Lunch is catered from Nourish Up formerly known as Friendship Trays. The center’s printed EPR plan and Ready to Go File were monitored current. It was explained that during the annual EPR portal review if no information changes, Ms. Carson only would need to print off page 28 (tracks the date anyone was in the portal system to show a review was completed annually). The center’s staff and training worksheet were monitored for compliance. Ms. Carson was able to print the required report from the ABCMS system. The staff names were current and compared to the presented staff and training worksheet. One new member of staff (E. Henderson) was hired after the last AC visit staff file was monitored for compliance. It was recommended to maintain offered paint in paint cups at each easel. We discussed broken crayons per ERS standards. Ms. Sullivan stated she would inquire with NCRLAP regarding current interpretation of materials. One area rug in space #4 was monitored with stains throughout. Ms. Carson stated the area rugs are cleaned every six months. I stated if the carpet is cleaned, and the stains remain after the next cleaning suggested the rug should be replaced. There were two NC Pre-K classrooms in operation. The Consultant’s report was printed and reviewed with Ms. Carson to ensure the current lead teacher and assistant teacher’s working in the NC Pre-K classrooms were current. The outdoor learning environment was remodeled this past summer. Large trees were removed, a trike path installed, retaining wall added and more natural shrubs were also added. A portion of the fence was monitored with protrusions at the top. Additionally, the space between the slats measured four inches and mesh was missing. The identified protrusions were not covered and the fence height was less than six feet. The last sanitation inspection was completed May 28, 2024, with four (4) demerits cited and a Superior classification issued. The center’s water was tested for lead and the results have not been received. It was recommended to reach out to the company because most results were received within three months of submitting the water samples. The last annual fire inspection was completed on October 1, 2024. It was recommended to begin your annual inspection process four to six weeks prior to expiration. Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Two sections of the outdoor fence was missing mesh or existing mesh was not connected properly. .0605(g) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A portion of the outdoor fence was monitored less than six feet, with protrusions. GS 110-91(6); .0605((i) Technical Assistance Provided and General Discussion: 1. Completed incident reports were monitored and maintained in a binder with the incident log. Completed incident reports should be maintained in each child’s applicable file. 2. It was recommended to purchase the third edition of the ERS. It was also recommended to review all available resources at the NCRLAP website. www.NCLRAP.org. There is an option for a facility to have a practice ERS if desired. 3. It was recommended to update the staff and training worksheets and email them to the consultant. Always maintain the worksheets current. 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, November 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 .0601 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 2/26/2024 Number Present: 58 Completed Date: 3/1/2024 Age: From 2 To 5 Total Minutes: 420 Time In: 09:30 AM Time Out: 04:30 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 by the family services coordinator of the program. She notified Ms. Carson of my presence. 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 #1-5, one bus and an outdoor learning environment was monitored for compliance. The operator stated they provided transportation in the afternoon and for field trips. One bus was monitored with a fire extinguisher and first aid kit. The fire extinguisher was not secured safely. The vehicle (JDK-4772) was monitored with current insurance that will expire May 20, 2024. A current safety inspection and registration were monitored. A transportation binder was monitored with children’s emergency contact information and a photograph of each transported child. It was recommended to add the driver’s emergency contact information and a copy of their NCDL to the maintained binder. Children were monitored eating their lunch, napping on mats, playing outside, and returning from a field trip. The center had signed permission slips for the field trip. However, the following rules were not met: (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity. (B) purpose of the activity. (C) time the activity will take place. (D) date of the activity. Two children with prescribed life altering medications were monitored without parental signed permission slips to administer the medications. One posted medical action plan was not completely filled in by either parent or physician. One electrical outlet in space #5 was not covered or made inaccessible to children. We discussed foam blocks maintained in a two-year-old classroom. There were not any observed holes in the foam blocks, but children’s teeth marks were observed. It was recommended to replace the foam blocks with an alternative. There were small parts of broken crayons, chalk in space #2. We discussed ensuring children’s paint, brushes and paper are ready for children to use. Seven children’s files were monitored for compliance. Four out of the seven monitored files were NC Pre-K files. One NC Pre-K child was missing a dental screening. Ms. Carson contacted the parents during the visit, and requested they email or text a picture of the missing screening. One NC Pre-K child was missing a signed discipline policy. The center implemented the Creative Curriculum with four-year-old children and NC Pre-K classrooms. The lead teacher provided documentation to show how they track parental involvement activities. Children’s phonetic assessments were monitored tracked by classroom staff. Creative Curriculum teacher guide books were monitored in each classroom. The NC Pre-K Consultant Site Visit Information form was reviewed with Ms. Carson to ensure its accuracy of the NC Pre-K teaching staff. The theme for the week were wheels. Charting of children’s responses were monitored on the bulletin boards in both NC Pre-K classrooms. Staff and Training worksheets were mailed emailed to me prior to the visit. There was one new staff person hired since the last Routine Unannounced visit dated November 29, 2023. Existing staff files were monitored from review of the submitted staff and training worksheets. The center’s EPR plan and Ready to Go File were monitored for compliance and found to meet child care requirements. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The outdoor learning environment was monitored with chipped paint throughout the back of the building. Debris was monitored throughout the only hard surface outdoors for children (side walk). There were many pieces of loose garbage. Fallen leaves and low levels shrubs/vines were monitored on the ground corners of the environment (a breeding ground for potential vermin). There was an exposed cable wire, and many exposed tree roots. There were fallen Gum Balls on the ground where two year old children occupy. We discussed using construction tape to tape off the areas within the fence children should no longer access until the remodel is completed or the identified areas are brought up to child care requirements. The last sanitation inspection was conducted October 23, 2023, with two (2) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on October 18, 2023. It was highly recommended to begin the annual inspection process 4-6 weeks prior to expiration. The center continues to meet five-star requirements and a three-year reassessment will be required no later than May 19, 2025. The last ERS were completed April 26, 2022. The overall average ERS was 5.08. It was recommended to begin reviewing any items scored under a 5.0. Violation Number Comment Rule 453 The schedule of off premise activities was not current and/or did not include required information. The NC Pre-K children in space #6 went on a field trip off site. The schedule was not developed nor posted in the applicable classroom. .1005(b)(5)(A-E) 707 Equipment and furnishings not meeting the requirements outlined in child care .0601(b) and (c) were not removed or made inaccessible. There were broken pieces of outdoor equipment (missing pedals, cracked plastic play pieces). .0601(d) 807 A safe indoor and outdoor environment was not provided for the children. There was an exposed cable wire and exposed tree roots. 10A NCAC 09 .0601(a) 808 The outdoor premises were not clean, drained and free of litter and hazardous materials grass and other vegetation in a manner which does not encourage vermin. There was loose pieces of garbage outside, fallen leaves and low growing weeds in the corners of the outdoor play area. 15A NCAC 18A .2832(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An electrical socket in space #5 was not in use or covered with a safety cover/plug. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Googgily eyes were monitored stored in the classroom cabinet in space #2, classroom serving two-year-old children. There were also broken crayons and chalk (small parts). .0604(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One staff person hired 1/10/24 did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1115 First aid kit and/or fire extinguisher was not located in vehicle; kit and/or extinguisher was not mounted or secured if in passenger area. The monitored fire extinguisher was not secured properly. 10A NCAC 09 .1003(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One child was monitored missing a signed discipline policy. .1804(c) 1769 The health assessment did not include a dental screening. A required dental screening was not on file for one child. .3005 (a)(5) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two children with noted chronic medical conditions did not have current permission slips to administer prescribed medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. The center’s not-for-profit corporation was listed as “current-active” by the NC Secretary of State’s office. 2. Ms. Carson informed me during the visit the center was awarded grant funds to reconfigure and remodel the outdoor learning environment. We discussed and reviewed the outdoor learning environment. There were many identified compliance issues. We discussed an alternative daily plan for children to obtain their daily outdoor time. The playground remodel will not begin until June 2024. Please submit plans for review. Make sure to file manufacturer’s equipment instructions. Parents will need to sign written permission for children to play outside of the fenced area if the entire fenced in outdoor area. It was recommended to also utilize www.NLI.org resources to help plan the outdoor environment. 3. We discussed ensuring all components of the children’s meal are served to children at the same time. Milk was observed being served to children after the plates were distributed to the children and the children were eating. We also discussed ensuring staff are seated at the table with the children during mealtimes. It was explained to the staff in space #5 why at least one staff should be seated in case a child chokes on their food and the staff’s ability to provide immediate assistance to the child. 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, March 11, 2024. 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: ratio. Open / not marked corrected.

10A NCAC 09 .0604 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 2/26/2024 Number Present: 58 Completed Date: 3/1/2024 Age: From 2 To 5 Total Minutes: 420 Time In: 09:30 AM Time Out: 04:30 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 by the family services coordinator of the program. She notified Ms. Carson of my presence. 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 #1-5, one bus and an outdoor learning environment was monitored for compliance. The operator stated they provided transportation in the afternoon and for field trips. One bus was monitored with a fire extinguisher and first aid kit. The fire extinguisher was not secured safely. The vehicle (JDK-4772) was monitored with current insurance that will expire May 20, 2024. A current safety inspection and registration were monitored. A transportation binder was monitored with children’s emergency contact information and a photograph of each transported child. It was recommended to add the driver’s emergency contact information and a copy of their NCDL to the maintained binder. Children were monitored eating their lunch, napping on mats, playing outside, and returning from a field trip. The center had signed permission slips for the field trip. However, the following rules were not met: (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity. (B) purpose of the activity. (C) time the activity will take place. (D) date of the activity. Two children with prescribed life altering medications were monitored without parental signed permission slips to administer the medications. One posted medical action plan was not completely filled in by either parent or physician. One electrical outlet in space #5 was not covered or made inaccessible to children. We discussed foam blocks maintained in a two-year-old classroom. There were not any observed holes in the foam blocks, but children’s teeth marks were observed. It was recommended to replace the foam blocks with an alternative. There were small parts of broken crayons, chalk in space #2. We discussed ensuring children’s paint, brushes and paper are ready for children to use. Seven children’s files were monitored for compliance. Four out of the seven monitored files were NC Pre-K files. One NC Pre-K child was missing a dental screening. Ms. Carson contacted the parents during the visit, and requested they email or text a picture of the missing screening. One NC Pre-K child was missing a signed discipline policy. The center implemented the Creative Curriculum with four-year-old children and NC Pre-K classrooms. The lead teacher provided documentation to show how they track parental involvement activities. Children’s phonetic assessments were monitored tracked by classroom staff. Creative Curriculum teacher guide books were monitored in each classroom. The NC Pre-K Consultant Site Visit Information form was reviewed with Ms. Carson to ensure its accuracy of the NC Pre-K teaching staff. The theme for the week were wheels. Charting of children’s responses were monitored on the bulletin boards in both NC Pre-K classrooms. Staff and Training worksheets were mailed emailed to me prior to the visit. There was one new staff person hired since the last Routine Unannounced visit dated November 29, 2023. Existing staff files were monitored from review of the submitted staff and training worksheets. The center’s EPR plan and Ready to Go File were monitored for compliance and found to meet child care requirements. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The outdoor learning environment was monitored with chipped paint throughout the back of the building. Debris was monitored throughout the only hard surface outdoors for children (side walk). There were many pieces of loose garbage. Fallen leaves and low levels shrubs/vines were monitored on the ground corners of the environment (a breeding ground for potential vermin). There was an exposed cable wire, and many exposed tree roots. There were fallen Gum Balls on the ground where two year old children occupy. We discussed using construction tape to tape off the areas within the fence children should no longer access until the remodel is completed or the identified areas are brought up to child care requirements. The last sanitation inspection was conducted October 23, 2023, with two (2) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on October 18, 2023. It was highly recommended to begin the annual inspection process 4-6 weeks prior to expiration. The center continues to meet five-star requirements and a three-year reassessment will be required no later than May 19, 2025. The last ERS were completed April 26, 2022. The overall average ERS was 5.08. It was recommended to begin reviewing any items scored under a 5.0. Violation Number Comment Rule 453 The schedule of off premise activities was not current and/or did not include required information. The NC Pre-K children in space #6 went on a field trip off site. The schedule was not developed nor posted in the applicable classroom. .1005(b)(5)(A-E) 707 Equipment and furnishings not meeting the requirements outlined in child care .0601(b) and (c) were not removed or made inaccessible. There were broken pieces of outdoor equipment (missing pedals, cracked plastic play pieces). .0601(d) 807 A safe indoor and outdoor environment was not provided for the children. There was an exposed cable wire and exposed tree roots. 10A NCAC 09 .0601(a) 808 The outdoor premises were not clean, drained and free of litter and hazardous materials grass and other vegetation in a manner which does not encourage vermin. There was loose pieces of garbage outside, fallen leaves and low growing weeds in the corners of the outdoor play area. 15A NCAC 18A .2832(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An electrical socket in space #5 was not in use or covered with a safety cover/plug. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Googgily eyes were monitored stored in the classroom cabinet in space #2, classroom serving two-year-old children. There were also broken crayons and chalk (small parts). .0604(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One staff person hired 1/10/24 did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1115 First aid kit and/or fire extinguisher was not located in vehicle; kit and/or extinguisher was not mounted or secured if in passenger area. The monitored fire extinguisher was not secured properly. 10A NCAC 09 .1003(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One child was monitored missing a signed discipline policy. .1804(c) 1769 The health assessment did not include a dental screening. A required dental screening was not on file for one child. .3005 (a)(5) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two children with noted chronic medical conditions did not have current permission slips to administer prescribed medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. The center’s not-for-profit corporation was listed as “current-active” by the NC Secretary of State’s office. 2. Ms. Carson informed me during the visit the center was awarded grant funds to reconfigure and remodel the outdoor learning environment. We discussed and reviewed the outdoor learning environment. There were many identified compliance issues. We discussed an alternative daily plan for children to obtain their daily outdoor time. The playground remodel will not begin until June 2024. Please submit plans for review. Make sure to file manufacturer’s equipment instructions. Parents will need to sign written permission for children to play outside of the fenced area if the entire fenced in outdoor area. It was recommended to also utilize www.NLI.org resources to help plan the outdoor environment. 3. We discussed ensuring all components of the children’s meal are served to children at the same time. Milk was observed being served to children after the plates were distributed to the children and the children were eating. We also discussed ensuring staff are seated at the table with the children during mealtimes. It was explained to the staff in space #5 why at least one staff should be seated in case a child chokes on their food and the staff’s ability to provide immediate assistance to the child. 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, March 11, 2024. 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 .0701 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 2/26/2024 Number Present: 58 Completed Date: 3/1/2024 Age: From 2 To 5 Total Minutes: 420 Time In: 09:30 AM Time Out: 04:30 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 by the family services coordinator of the program. She notified Ms. Carson of my presence. 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 #1-5, one bus and an outdoor learning environment was monitored for compliance. The operator stated they provided transportation in the afternoon and for field trips. One bus was monitored with a fire extinguisher and first aid kit. The fire extinguisher was not secured safely. The vehicle (JDK-4772) was monitored with current insurance that will expire May 20, 2024. A current safety inspection and registration were monitored. A transportation binder was monitored with children’s emergency contact information and a photograph of each transported child. It was recommended to add the driver’s emergency contact information and a copy of their NCDL to the maintained binder. Children were monitored eating their lunch, napping on mats, playing outside, and returning from a field trip. The center had signed permission slips for the field trip. However, the following rules were not met: (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity. (B) purpose of the activity. (C) time the activity will take place. (D) date of the activity. Two children with prescribed life altering medications were monitored without parental signed permission slips to administer the medications. One posted medical action plan was not completely filled in by either parent or physician. One electrical outlet in space #5 was not covered or made inaccessible to children. We discussed foam blocks maintained in a two-year-old classroom. There were not any observed holes in the foam blocks, but children’s teeth marks were observed. It was recommended to replace the foam blocks with an alternative. There were small parts of broken crayons, chalk in space #2. We discussed ensuring children’s paint, brushes and paper are ready for children to use. Seven children’s files were monitored for compliance. Four out of the seven monitored files were NC Pre-K files. One NC Pre-K child was missing a dental screening. Ms. Carson contacted the parents during the visit, and requested they email or text a picture of the missing screening. One NC Pre-K child was missing a signed discipline policy. The center implemented the Creative Curriculum with four-year-old children and NC Pre-K classrooms. The lead teacher provided documentation to show how they track parental involvement activities. Children’s phonetic assessments were monitored tracked by classroom staff. Creative Curriculum teacher guide books were monitored in each classroom. The NC Pre-K Consultant Site Visit Information form was reviewed with Ms. Carson to ensure its accuracy of the NC Pre-K teaching staff. The theme for the week were wheels. Charting of children’s responses were monitored on the bulletin boards in both NC Pre-K classrooms. Staff and Training worksheets were mailed emailed to me prior to the visit. There was one new staff person hired since the last Routine Unannounced visit dated November 29, 2023. Existing staff files were monitored from review of the submitted staff and training worksheets. The center’s EPR plan and Ready to Go File were monitored for compliance and found to meet child care requirements. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The outdoor learning environment was monitored with chipped paint throughout the back of the building. Debris was monitored throughout the only hard surface outdoors for children (side walk). There were many pieces of loose garbage. Fallen leaves and low levels shrubs/vines were monitored on the ground corners of the environment (a breeding ground for potential vermin). There was an exposed cable wire, and many exposed tree roots. There were fallen Gum Balls on the ground where two year old children occupy. We discussed using construction tape to tape off the areas within the fence children should no longer access until the remodel is completed or the identified areas are brought up to child care requirements. The last sanitation inspection was conducted October 23, 2023, with two (2) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on October 18, 2023. It was highly recommended to begin the annual inspection process 4-6 weeks prior to expiration. The center continues to meet five-star requirements and a three-year reassessment will be required no later than May 19, 2025. The last ERS were completed April 26, 2022. The overall average ERS was 5.08. It was recommended to begin reviewing any items scored under a 5.0. Violation Number Comment Rule 453 The schedule of off premise activities was not current and/or did not include required information. The NC Pre-K children in space #6 went on a field trip off site. The schedule was not developed nor posted in the applicable classroom. .1005(b)(5)(A-E) 707 Equipment and furnishings not meeting the requirements outlined in child care .0601(b) and (c) were not removed or made inaccessible. There were broken pieces of outdoor equipment (missing pedals, cracked plastic play pieces). .0601(d) 807 A safe indoor and outdoor environment was not provided for the children. There was an exposed cable wire and exposed tree roots. 10A NCAC 09 .0601(a) 808 The outdoor premises were not clean, drained and free of litter and hazardous materials grass and other vegetation in a manner which does not encourage vermin. There was loose pieces of garbage outside, fallen leaves and low growing weeds in the corners of the outdoor play area. 15A NCAC 18A .2832(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An electrical socket in space #5 was not in use or covered with a safety cover/plug. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Googgily eyes were monitored stored in the classroom cabinet in space #2, classroom serving two-year-old children. There were also broken crayons and chalk (small parts). .0604(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One staff person hired 1/10/24 did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1115 First aid kit and/or fire extinguisher was not located in vehicle; kit and/or extinguisher was not mounted or secured if in passenger area. The monitored fire extinguisher was not secured properly. 10A NCAC 09 .1003(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One child was monitored missing a signed discipline policy. .1804(c) 1769 The health assessment did not include a dental screening. A required dental screening was not on file for one child. .3005 (a)(5) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two children with noted chronic medical conditions did not have current permission slips to administer prescribed medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. The center’s not-for-profit corporation was listed as “current-active” by the NC Secretary of State’s office. 2. Ms. Carson informed me during the visit the center was awarded grant funds to reconfigure and remodel the outdoor learning environment. We discussed and reviewed the outdoor learning environment. There were many identified compliance issues. We discussed an alternative daily plan for children to obtain their daily outdoor time. The playground remodel will not begin until June 2024. Please submit plans for review. Make sure to file manufacturer’s equipment instructions. Parents will need to sign written permission for children to play outside of the fenced area if the entire fenced in outdoor area. It was recommended to also utilize www.NLI.org resources to help plan the outdoor environment. 3. We discussed ensuring all components of the children’s meal are served to children at the same time. Milk was observed being served to children after the plates were distributed to the children and the children were eating. We also discussed ensuring staff are seated at the table with the children during mealtimes. It was explained to the staff in space #5 why at least one staff should be seated in case a child chokes on their food and the staff’s ability to provide immediate assistance to the child. 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, March 11, 2024. 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 .1003 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 2/26/2024 Number Present: 58 Completed Date: 3/1/2024 Age: From 2 To 5 Total Minutes: 420 Time In: 09:30 AM Time Out: 04:30 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 by the family services coordinator of the program. She notified Ms. Carson of my presence. 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 #1-5, one bus and an outdoor learning environment was monitored for compliance. The operator stated they provided transportation in the afternoon and for field trips. One bus was monitored with a fire extinguisher and first aid kit. The fire extinguisher was not secured safely. The vehicle (JDK-4772) was monitored with current insurance that will expire May 20, 2024. A current safety inspection and registration were monitored. A transportation binder was monitored with children’s emergency contact information and a photograph of each transported child. It was recommended to add the driver’s emergency contact information and a copy of their NCDL to the maintained binder. Children were monitored eating their lunch, napping on mats, playing outside, and returning from a field trip. The center had signed permission slips for the field trip. However, the following rules were not met: (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity. (B) purpose of the activity. (C) time the activity will take place. (D) date of the activity. Two children with prescribed life altering medications were monitored without parental signed permission slips to administer the medications. One posted medical action plan was not completely filled in by either parent or physician. One electrical outlet in space #5 was not covered or made inaccessible to children. We discussed foam blocks maintained in a two-year-old classroom. There were not any observed holes in the foam blocks, but children’s teeth marks were observed. It was recommended to replace the foam blocks with an alternative. There were small parts of broken crayons, chalk in space #2. We discussed ensuring children’s paint, brushes and paper are ready for children to use. Seven children’s files were monitored for compliance. Four out of the seven monitored files were NC Pre-K files. One NC Pre-K child was missing a dental screening. Ms. Carson contacted the parents during the visit, and requested they email or text a picture of the missing screening. One NC Pre-K child was missing a signed discipline policy. The center implemented the Creative Curriculum with four-year-old children and NC Pre-K classrooms. The lead teacher provided documentation to show how they track parental involvement activities. Children’s phonetic assessments were monitored tracked by classroom staff. Creative Curriculum teacher guide books were monitored in each classroom. The NC Pre-K Consultant Site Visit Information form was reviewed with Ms. Carson to ensure its accuracy of the NC Pre-K teaching staff. The theme for the week were wheels. Charting of children’s responses were monitored on the bulletin boards in both NC Pre-K classrooms. Staff and Training worksheets were mailed emailed to me prior to the visit. There was one new staff person hired since the last Routine Unannounced visit dated November 29, 2023. Existing staff files were monitored from review of the submitted staff and training worksheets. The center’s EPR plan and Ready to Go File were monitored for compliance and found to meet child care requirements. Documentation for quarterly safety drills and monthly fire drills were discussed and monitored. The outdoor learning environment was monitored with chipped paint throughout the back of the building. Debris was monitored throughout the only hard surface outdoors for children (side walk). There were many pieces of loose garbage. Fallen leaves and low levels shrubs/vines were monitored on the ground corners of the environment (a breeding ground for potential vermin). There was an exposed cable wire, and many exposed tree roots. There were fallen Gum Balls on the ground where two year old children occupy. We discussed using construction tape to tape off the areas within the fence children should no longer access until the remodel is completed or the identified areas are brought up to child care requirements. The last sanitation inspection was conducted October 23, 2023, with two (2) demerits cited, and a Superior Classification issued. The last annual fire inspection was completed on October 18, 2023. It was highly recommended to begin the annual inspection process 4-6 weeks prior to expiration. The center continues to meet five-star requirements and a three-year reassessment will be required no later than May 19, 2025. The last ERS were completed April 26, 2022. The overall average ERS was 5.08. It was recommended to begin reviewing any items scored under a 5.0. Violation Number Comment Rule 453 The schedule of off premise activities was not current and/or did not include required information. The NC Pre-K children in space #6 went on a field trip off site. The schedule was not developed nor posted in the applicable classroom. .1005(b)(5)(A-E) 707 Equipment and furnishings not meeting the requirements outlined in child care .0601(b) and (c) were not removed or made inaccessible. There were broken pieces of outdoor equipment (missing pedals, cracked plastic play pieces). .0601(d) 807 A safe indoor and outdoor environment was not provided for the children. There was an exposed cable wire and exposed tree roots. 10A NCAC 09 .0601(a) 808 The outdoor premises were not clean, drained and free of litter and hazardous materials grass and other vegetation in a manner which does not encourage vermin. There was loose pieces of garbage outside, fallen leaves and low growing weeds in the corners of the outdoor play area. 15A NCAC 18A .2832(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An electrical socket in space #5 was not in use or covered with a safety cover/plug. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Googgily eyes were monitored stored in the classroom cabinet in space #2, classroom serving two-year-old children. There were also broken crayons and chalk (small parts). .0604(q) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One staff person hired 1/10/24 did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1115 First aid kit and/or fire extinguisher was not located in vehicle; kit and/or extinguisher was not mounted or secured if in passenger area. The monitored fire extinguisher was not secured properly. 10A NCAC 09 .1003(c) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. One child was monitored missing a signed discipline policy. .1804(c) 1769 The health assessment did not include a dental screening. A required dental screening was not on file for one child. .3005 (a)(5) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two children with noted chronic medical conditions did not have current permission slips to administer prescribed medications. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance Provided and General Discussion: 1. The center’s not-for-profit corporation was listed as “current-active” by the NC Secretary of State’s office. 2. Ms. Carson informed me during the visit the center was awarded grant funds to reconfigure and remodel the outdoor learning environment. We discussed and reviewed the outdoor learning environment. There were many identified compliance issues. We discussed an alternative daily plan for children to obtain their daily outdoor time. The playground remodel will not begin until June 2024. Please submit plans for review. Make sure to file manufacturer’s equipment instructions. Parents will need to sign written permission for children to play outside of the fenced area if the entire fenced in outdoor area. It was recommended to also utilize www.NLI.org resources to help plan the outdoor environment. 3. We discussed ensuring all components of the children’s meal are served to children at the same time. Milk was observed being served to children after the plates were distributed to the children and the children were eating. We also discussed ensuring staff are seated at the table with the children during mealtimes. It was explained to the staff in space #5 why at least one staff should be seated in case a child chokes on their food and the staff’s ability to provide immediate assistance to the child. 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, March 11, 2024. 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 .0607 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 11/29/2023 Number Present: 59 Completed Date: 11/29/2023 Age: From 2 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during a Routine Unannounced Visit. Upon arrival at the center, the on-site administrator, Ms. Lizzie Carson, was present and working in her office. The child care item number listing dated August 2023 was used to document compliance. A walk through of spaces #1-6 were completed with Ms. Carson. Children were observed eating their lunch of sliced chicken, yams, wheat bread, pineapples, and milk. There was a child with a posted allergy with asthma. There was not a medical action plan on file or an inhaler for staff to administer if required. Another child’s medical action plan was outdated and expired in the summer of 2023. We discussed concerns related to a parent listing on their child’s application that their child has an allergy to a food, but there is not a medical action or doctors notes, or allergy test results provided. We discussed if a parent lists on their child’s application their child has a food allergy, the program is expected to list the child’s allergy on the posted allergy list and have a current medical action plan on file. If medication is listed on the medical action plan, the medication must be maintained on site when the child is in care. No new staff members were hired since the last RU visit completed May 9, 2023. Ms. Carson was updating the staff and training worksheets. The previous worksheets on file were copied and safety certifications and health requirements were monitored from the worksheets. Ms. Carson was asked to retrieve staff files to show compliance with the annual review of the center’s EPR plan and Center Emergency Medical Care Plan, CPR and FA certifications and Health and Safety Training. One staff person was passed due to renew CMT training. One staff person did not have the proper documentation on file related to FA. The center did have an EPR Plan and Ready to Go File. However, the EPR plan was not updated in the electronically stored template. The current consultant’s information was not current. Ms. Carson stated the previous consultant informed her it needed to be updated but did not specify that it needed to be updated in the electronically stored template system. The link from the DCDEEE web page was emailed to Ms. Carson to update all information in the electronic stored system. The last sanitation inspection was completed October 23, 2023, with twelve (12) demerits cited and a Superior classification issued. The last annual fire inspection was completed on October 18, 2023. The last ERS were completed April 26, 2022. The last rated license reassessment was processed May 19, 2022. Based on the DCDEE Cohort model plan the center will be required to be reassessed by May of 2025. Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff person did not have First Aid documentation. The documentation provided only listed CPR. .1102(c) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child listed with asthma did not have a medical action plan or inhaler on site. .0801(b) 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 updated annually. The child's medical action plan expired July 2023. .0801(b) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. One staff person was past due to renew Recognizing and Responding to Child Maltreatment training every five years. .1103(b) Technical Assistance Provided and General Discussion: 1. The center’s last safety drill was completed May of 2023. The program does not operate during summer months. I explained to Ms. Carson the expectation of the program would be to conduct either safety drill sometime during the first month of operation once children return to the program and building. 2. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (a) For the purposes of this Rule, the Emergency Preparedness and Response in Child Care is a session training developed by the North Carolina Child Care Health and Safety Resource Center for child care operators and providers on creating an Emergency Preparedness and Response Plan and practicing, responding to, and recovering from emergencies in child care centers. (b) Existing child care centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training. New centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completes the required training within four months of the vacancy. Documentation of completion of the training shall be maintained in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (c) Upon completion of the Emergency Preparedness and Response in Child Care training, the trained staff shall develop the Emergency Preparedness and Response Plan. The Emergency Preparedness and Response Plan means a written plan that addresses how a child care center will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, blizzards, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/# and completed within four months of completion of the Emergency Preparedness and Response in Child Care training. (d) The Emergency Preparedness and Response Plan shall include: (1) written procedures for accounting for all in attendance including: (A) the location of the children, staff, volunteer, and visitor attendance lists; and (B) the name of the person(s) responsible for bringing the children, staff, volunteer, and visitor attendance lists in the event of an emergency. (2) a description for how and when children shall be transported; (3) methods for communicating with parents and emergency personnel or law enforcement; (4) a description of how children's nutritional and health needs will be met; (5) the relocation and reunification process; (6) emergency telephone numbers; (7) evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during an emergency; (8) the date of the last revision of the plan; (9) specific considerations for non-mobile children and children with special needs; and (10) the location of a Ready to Go File. A Ready to Go File means a collection of information on children, staff and the facility, to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Child Care, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (g) All substitutes and volunteers counted in ratio shall be informed of the child care center's Emergency Preparedness and Response Plan and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. (h) Centers operated by a Local Education Agency that have completed critical incident training and a School Risk Management Plan as set forth by the Department of Public Instruction shall be exempt from Paragraphs (a) through (e) of this Rule. When a School Risk Management Plan has been completed, the requirements of Paragraphs (f) and (g) of this Rule shall be applicable. The School Risk Management Plan shall be available for review by the Division. More information regarding the School Risk Management Plan is located online at https://sera.nc.gov/srmp/. History Note: Authority G.S. 110-85; 143B-168.3; Eff. July 1, 2015; Amended Eff. August 1, 2015; Readopted Eff. October 1, 2017; Amended Eff February 1, 2021. 3. 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; 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 Wednesday, December 13, 2023. You may email me your letter of correction. 4. We reviewed how to ensure staff’s CPR and FA documentation meets DCDEE requirements. Ms. Carson was emailed a link to the DCDEE web page. One staff person was hired with BLS documentation only. The documentation only showed the caregiver was trained in CPR only. 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: ratio. Open / not marked corrected.

10A NCAC 09 .0803 · Violation

Name of Operation: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 11/29/2023 Number Present: 59 Completed Date: 11/29/2023 Age: From 2 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during a Routine Unannounced Visit. Upon arrival at the center, the on-site administrator, Ms. Lizzie Carson, was present and working in her office. The child care item number listing dated August 2023 was used to document compliance. A walk through of spaces #1-6 were completed with Ms. Carson. Children were observed eating their lunch of sliced chicken, yams, wheat bread, pineapples, and milk. There was a child with a posted allergy with asthma. There was not a medical action plan on file or an inhaler for staff to administer if required. Another child’s medical action plan was outdated and expired in the summer of 2023. We discussed concerns related to a parent listing on their child’s application that their child has an allergy to a food, but there is not a medical action or doctors notes, or allergy test results provided. We discussed if a parent lists on their child’s application their child has a food allergy, the program is expected to list the child’s allergy on the posted allergy list and have a current medical action plan on file. If medication is listed on the medical action plan, the medication must be maintained on site when the child is in care. No new staff members were hired since the last RU visit completed May 9, 2023. Ms. Carson was updating the staff and training worksheets. The previous worksheets on file were copied and safety certifications and health requirements were monitored from the worksheets. Ms. Carson was asked to retrieve staff files to show compliance with the annual review of the center’s EPR plan and Center Emergency Medical Care Plan, CPR and FA certifications and Health and Safety Training. One staff person was passed due to renew CMT training. One staff person did not have the proper documentation on file related to FA. The center did have an EPR Plan and Ready to Go File. However, the EPR plan was not updated in the electronically stored template. The current consultant’s information was not current. Ms. Carson stated the previous consultant informed her it needed to be updated but did not specify that it needed to be updated in the electronically stored template system. The link from the DCDEEE web page was emailed to Ms. Carson to update all information in the electronic stored system. The last sanitation inspection was completed October 23, 2023, with twelve (12) demerits cited and a Superior classification issued. The last annual fire inspection was completed on October 18, 2023. The last ERS were completed April 26, 2022. The last rated license reassessment was processed May 19, 2022. Based on the DCDEE Cohort model plan the center will be required to be reassessed by May of 2025. Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff person did not have First Aid documentation. The documentation provided only listed CPR. .1102(c) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child listed with asthma did not have a medical action plan or inhaler on site. .0801(b) 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 updated annually. The child's medical action plan expired July 2023. .0801(b) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. One staff person was past due to renew Recognizing and Responding to Child Maltreatment training every five years. .1103(b) Technical Assistance Provided and General Discussion: 1. The center’s last safety drill was completed May of 2023. The program does not operate during summer months. I explained to Ms. Carson the expectation of the program would be to conduct either safety drill sometime during the first month of operation once children return to the program and building. 2. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (a) For the purposes of this Rule, the Emergency Preparedness and Response in Child Care is a session training developed by the North Carolina Child Care Health and Safety Resource Center for child care operators and providers on creating an Emergency Preparedness and Response Plan and practicing, responding to, and recovering from emergencies in child care centers. (b) Existing child care centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training. New centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completes the required training within four months of the vacancy. Documentation of completion of the training shall be maintained in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (c) Upon completion of the Emergency Preparedness and Response in Child Care training, the trained staff shall develop the Emergency Preparedness and Response Plan. The Emergency Preparedness and Response Plan means a written plan that addresses how a child care center will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, blizzards, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/# and completed within four months of completion of the Emergency Preparedness and Response in Child Care training. (d) The Emergency Preparedness and Response Plan shall include: (1) written procedures for accounting for all in attendance including: (A) the location of the children, staff, volunteer, and visitor attendance lists; and (B) the name of the person(s) responsible for bringing the children, staff, volunteer, and visitor attendance lists in the event of an emergency. (2) a description for how and when children shall be transported; (3) methods for communicating with parents and emergency personnel or law enforcement; (4) a description of how children's nutritional and health needs will be met; (5) the relocation and reunification process; (6) emergency telephone numbers; (7) evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during an emergency; (8) the date of the last revision of the plan; (9) specific considerations for non-mobile children and children with special needs; and (10) the location of a Ready to Go File. A Ready to Go File means a collection of information on children, staff and the facility, to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Child Care, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (g) All substitutes and volunteers counted in ratio shall be informed of the child care center's Emergency Preparedness and Response Plan and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. (h) Centers operated by a Local Education Agency that have completed critical incident training and a School Risk Management Plan as set forth by the Department of Public Instruction shall be exempt from Paragraphs (a) through (e) of this Rule. When a School Risk Management Plan has been completed, the requirements of Paragraphs (f) and (g) of this Rule shall be applicable. The School Risk Management Plan shall be available for review by the Division. More information regarding the School Risk Management Plan is located online at https://sera.nc.gov/srmp/. History Note: Authority G.S. 110-85; 143B-168.3; Eff. July 1, 2015; Amended Eff. August 1, 2015; Readopted Eff. October 1, 2017; Amended Eff February 1, 2021. 3. 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; 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 Wednesday, December 13, 2023. You may email me your letter of correction. 4. We reviewed how to ensure staff’s CPR and FA documentation meets DCDEE requirements. Ms. Carson was emailed a link to the DCDEE web page. One staff person was hired with BLS documentation only. The documentation only showed the caregiver was trained in CPR only. 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: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 11/29/2023 Number Present: 59 Completed Date: 11/29/2023 Age: From 2 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during a Routine Unannounced Visit. Upon arrival at the center, the on-site administrator, Ms. Lizzie Carson, was present and working in her office. The child care item number listing dated August 2023 was used to document compliance. A walk through of spaces #1-6 were completed with Ms. Carson. Children were observed eating their lunch of sliced chicken, yams, wheat bread, pineapples, and milk. There was a child with a posted allergy with asthma. There was not a medical action plan on file or an inhaler for staff to administer if required. Another child’s medical action plan was outdated and expired in the summer of 2023. We discussed concerns related to a parent listing on their child’s application that their child has an allergy to a food, but there is not a medical action or doctors notes, or allergy test results provided. We discussed if a parent lists on their child’s application their child has a food allergy, the program is expected to list the child’s allergy on the posted allergy list and have a current medical action plan on file. If medication is listed on the medical action plan, the medication must be maintained on site when the child is in care. No new staff members were hired since the last RU visit completed May 9, 2023. Ms. Carson was updating the staff and training worksheets. The previous worksheets on file were copied and safety certifications and health requirements were monitored from the worksheets. Ms. Carson was asked to retrieve staff files to show compliance with the annual review of the center’s EPR plan and Center Emergency Medical Care Plan, CPR and FA certifications and Health and Safety Training. One staff person was passed due to renew CMT training. One staff person did not have the proper documentation on file related to FA. The center did have an EPR Plan and Ready to Go File. However, the EPR plan was not updated in the electronically stored template. The current consultant’s information was not current. Ms. Carson stated the previous consultant informed her it needed to be updated but did not specify that it needed to be updated in the electronically stored template system. The link from the DCDEEE web page was emailed to Ms. Carson to update all information in the electronic stored system. The last sanitation inspection was completed October 23, 2023, with twelve (12) demerits cited and a Superior classification issued. The last annual fire inspection was completed on October 18, 2023. The last ERS were completed April 26, 2022. The last rated license reassessment was processed May 19, 2022. Based on the DCDEE Cohort model plan the center will be required to be reassessed by May of 2025. Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff person did not have First Aid documentation. The documentation provided only listed CPR. .1102(c) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child listed with asthma did not have a medical action plan or inhaler on site. .0801(b) 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 updated annually. The child's medical action plan expired July 2023. .0801(b) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. One staff person was past due to renew Recognizing and Responding to Child Maltreatment training every five years. .1103(b) Technical Assistance Provided and General Discussion: 1. The center’s last safety drill was completed May of 2023. The program does not operate during summer months. I explained to Ms. Carson the expectation of the program would be to conduct either safety drill sometime during the first month of operation once children return to the program and building. 2. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (a) For the purposes of this Rule, the Emergency Preparedness and Response in Child Care is a session training developed by the North Carolina Child Care Health and Safety Resource Center for child care operators and providers on creating an Emergency Preparedness and Response Plan and practicing, responding to, and recovering from emergencies in child care centers. (b) Existing child care centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training. New centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completes the required training within four months of the vacancy. Documentation of completion of the training shall be maintained in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (c) Upon completion of the Emergency Preparedness and Response in Child Care training, the trained staff shall develop the Emergency Preparedness and Response Plan. The Emergency Preparedness and Response Plan means a written plan that addresses how a child care center will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, blizzards, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/# and completed within four months of completion of the Emergency Preparedness and Response in Child Care training. (d) The Emergency Preparedness and Response Plan shall include: (1) written procedures for accounting for all in attendance including: (A) the location of the children, staff, volunteer, and visitor attendance lists; and (B) the name of the person(s) responsible for bringing the children, staff, volunteer, and visitor attendance lists in the event of an emergency. (2) a description for how and when children shall be transported; (3) methods for communicating with parents and emergency personnel or law enforcement; (4) a description of how children's nutritional and health needs will be met; (5) the relocation and reunification process; (6) emergency telephone numbers; (7) evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during an emergency; (8) the date of the last revision of the plan; (9) specific considerations for non-mobile children and children with special needs; and (10) the location of a Ready to Go File. A Ready to Go File means a collection of information on children, staff and the facility, to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Child Care, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (g) All substitutes and volunteers counted in ratio shall be informed of the child care center's Emergency Preparedness and Response Plan and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. (h) Centers operated by a Local Education Agency that have completed critical incident training and a School Risk Management Plan as set forth by the Department of Public Instruction shall be exempt from Paragraphs (a) through (e) of this Rule. When a School Risk Management Plan has been completed, the requirements of Paragraphs (f) and (g) of this Rule shall be applicable. The School Risk Management Plan shall be available for review by the Division. More information regarding the School Risk Management Plan is located online at https://sera.nc.gov/srmp/. History Note: Authority G.S. 110-85; 143B-168.3; Eff. July 1, 2015; Amended Eff. August 1, 2015; Readopted Eff. October 1, 2017; Amended Eff February 1, 2021. 3. 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; 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 Wednesday, December 13, 2023. You may email me your letter of correction. 4. We reviewed how to ensure staff’s CPR and FA documentation meets DCDEE requirements. Ms. Carson was emailed a link to the DCDEE web page. One staff person was hired with BLS documentation only. The documentation only showed the caregiver was trained in CPR only. 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: THE LEARNING COLLABORATIVE Facility ID: 60003775 Consultant: MARA BRINTON Operation Type: Center Case Number: Visit Date: 11/29/2023 Number Present: 59 Completed Date: 11/29/2023 Age: From 2 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance with applicable child care requirements during a Routine Unannounced Visit. Upon arrival at the center, the on-site administrator, Ms. Lizzie Carson, was present and working in her office. The child care item number listing dated August 2023 was used to document compliance. A walk through of spaces #1-6 were completed with Ms. Carson. Children were observed eating their lunch of sliced chicken, yams, wheat bread, pineapples, and milk. There was a child with a posted allergy with asthma. There was not a medical action plan on file or an inhaler for staff to administer if required. Another child’s medical action plan was outdated and expired in the summer of 2023. We discussed concerns related to a parent listing on their child’s application that their child has an allergy to a food, but there is not a medical action or doctors notes, or allergy test results provided. We discussed if a parent lists on their child’s application their child has a food allergy, the program is expected to list the child’s allergy on the posted allergy list and have a current medical action plan on file. If medication is listed on the medical action plan, the medication must be maintained on site when the child is in care. No new staff members were hired since the last RU visit completed May 9, 2023. Ms. Carson was updating the staff and training worksheets. The previous worksheets on file were copied and safety certifications and health requirements were monitored from the worksheets. Ms. Carson was asked to retrieve staff files to show compliance with the annual review of the center’s EPR plan and Center Emergency Medical Care Plan, CPR and FA certifications and Health and Safety Training. One staff person was passed due to renew CMT training. One staff person did not have the proper documentation on file related to FA. The center did have an EPR Plan and Ready to Go File. However, the EPR plan was not updated in the electronically stored template. The current consultant’s information was not current. Ms. Carson stated the previous consultant informed her it needed to be updated but did not specify that it needed to be updated in the electronically stored template system. The link from the DCDEEE web page was emailed to Ms. Carson to update all information in the electronic stored system. The last sanitation inspection was completed October 23, 2023, with twelve (12) demerits cited and a Superior classification issued. The last annual fire inspection was completed on October 18, 2023. The last ERS were completed April 26, 2022. The last rated license reassessment was processed May 19, 2022. Based on the DCDEE Cohort model plan the center will be required to be reassessed by May of 2025. Violation Number Comment Rule 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff person did not have First Aid documentation. The documentation provided only listed CPR. .1102(c) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child listed with asthma did not have a medical action plan or inhaler on site. .0801(b) 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 updated annually. The child's medical action plan expired July 2023. .0801(b) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. One staff person was past due to renew Recognizing and Responding to Child Maltreatment training every five years. .1103(b) Technical Assistance Provided and General Discussion: 1. The center’s last safety drill was completed May of 2023. The program does not operate during summer months. I explained to Ms. Carson the expectation of the program would be to conduct either safety drill sometime during the first month of operation once children return to the program and building. 2. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (a) For the purposes of this Rule, the Emergency Preparedness and Response in Child Care is a session training developed by the North Carolina Child Care Health and Safety Resource Center for child care operators and providers on creating an Emergency Preparedness and Response Plan and practicing, responding to, and recovering from emergencies in child care centers. (b) Existing child care centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training. New centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completes the required training within four months of the vacancy. Documentation of completion of the training shall be maintained in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (c) Upon completion of the Emergency Preparedness and Response in Child Care training, the trained staff shall develop the Emergency Preparedness and Response Plan. The Emergency Preparedness and Response Plan means a written plan that addresses how a child care center will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, blizzards, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. This Plan must be on a template provided by the Division available at https://rmp.nc.gov/portal/# and completed within four months of completion of the Emergency Preparedness and Response in Child Care training. (d) The Emergency Preparedness and Response Plan shall include: (1) written procedures for accounting for all in attendance including: (A) the location of the children, staff, volunteer, and visitor attendance lists; and (B) the name of the person(s) responsible for bringing the children, staff, volunteer, and visitor attendance lists in the event of an emergency. (2) a description for how and when children shall be transported; (3) methods for communicating with parents and emergency personnel or law enforcement; (4) a description of how children's nutritional and health needs will be met; (5) the relocation and reunification process; (6) emergency telephone numbers; (7) evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during an emergency; (8) the date of the last revision of the plan; (9) specific considerations for non-mobile children and children with special needs; and (10) the location of a Ready to Go File. A Ready to Go File means a collection of information on children, staff and the facility, to utilize, if an evacuation occurs. The file shall include, a copy of the Emergency Preparedness and Response Plan, contact information for individuals to pick-up children, each child's Application for Child Care, medication authorizations and instructions, any action plans for children with special health care needs, a list of any known food allergies of children and staff, staff contact information, Incident Report forms, an area map, and emergency telephone numbers. (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. (g) All substitutes and volunteers counted in ratio shall be informed of the child care center's Emergency Preparedness and Response Plan and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. (h) Centers operated by a Local Education Agency that have completed critical incident training and a School Risk Management Plan as set forth by the Department of Public Instruction shall be exempt from Paragraphs (a) through (e) of this Rule. When a School Risk Management Plan has been completed, the requirements of Paragraphs (f) and (g) of this Rule shall be applicable. The School Risk Management Plan shall be available for review by the Division. More information regarding the School Risk Management Plan is located online at https://sera.nc.gov/srmp/. History Note: Authority G.S. 110-85; 143B-168.3; Eff. July 1, 2015; Amended Eff. August 1, 2015; Readopted Eff. October 1, 2017; Amended Eff February 1, 2021. 3. 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; 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 Wednesday, December 13, 2023. You may email me your letter of correction. 4. We reviewed how to ensure staff’s CPR and FA documentation meets DCDEE requirements. Ms. Carson was emailed a link to the DCDEE web page. One staff person was hired with BLS documentation only. The documentation only showed the caregiver was trained in CPR only. 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