10A NCAC 09 .3009 · Violation

Name of Operation: FORBUSH PRESCHOOL Facility ID: 99000085 Consultant: JENNIFER DAVIS Operation Type: Center Case Number: Visit Date: 2/13/2025 Number Present: 15 Completed Date: 2/13/2025 Age: From 3 To 5 Total Minutes: 120 Time In: 09:00 AM Time Out: 11:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 , where children participating in the NC Pre-K program are cared for. This visit was conducted by Jennifer Davis, childcare consultant with Tiffany Eddleman, lead teacher. Currently this program operates with a FIVE (5) Star License issued 10/19/17. License restrictions include daytime care only; enhanced ratios minus one; meets enhanced ratios; meets enhanced space. This program is operated by Yadkin County Schools. Currently there is one preschool class with NC Pre-K enrollment. There are full-time and part-time children enrolled in the program. The license was posted, and restrictions were met. The program’s compliance history was 97% prior to today’s visit. All programs are required to maintain at least 75% compliance. The last annual compliance visit was conducted on 2/21/24. A sanitation inspection was completed on 9/11/24 with a Superior classification. A fire inspection was conducted on 9/26/24. All indoor and outdoor areas were observed and monitored during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed the children playing in centers during the visit. I observed positive interactions between staff and children. Storage of hazardous items was monitored. I observed three emergency medications. I observed a DPI off-site transportation form (8/14/24). Program records and required postings were monitored. A fire drill was documented on 1/17/25. A shelter-in-place drill was documented on 11/13/24. A playground inspection was documented on 2/3/25. Staff records were monitored per DCDEE procedure. Children’s records were monitored per DCDEE procedures. DPI offsite verification forms for staff records (8/13/24) and children’s records (8/13/24) were observed. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Tiffany Eddleman, and teacher, Jennifer Sink. Four files were monitored for completed health assessments and developmental screenings. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Teaching Strategies Gold. You stated you were in the process of completing the mid year screenings. The center uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress and documentation was viewed today. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year. The first day of school was August 14, 2024. The classroom operates from 7:30 a.m. to 2:30p.m. Parent conferences are held three times per year. You stated that you use dojo to communicate with parents. In addition, a monthly newsletter is sent home for additional information. You verified that you incorporate family engagement by inviting parents in for special events such as reading and also have family nights in conjunction with the school. Ms. Eddleman stated that there is an open door policy in the classroom for parents. The environment rating scale score received in 2017 was 5.86. The following violations were cited during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One expired medication was not returned to the parent or discarded. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). One staff member had an expired qualification letter. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for one staff member. G.S. 110-90.2(b) & (d) & .2703(e) 1768 The health assessment did not include a hearing screening. One enrolled child did not have a hearing screening on file. .3005 (a)(4) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. COMPLIANCE DOCUMENTATION: You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 2/27/25. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • the name of your center, • facility ID number, • date, • title of the person who signs the letter You may email the letter to jennifer.davis@dhhs.nc.gov If you state in your documentation or report that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Technical assistance provided during today’s visit: -Any staff working in the classroom and the principal should have a current qualification letter on file. -For NC Pre-K screenings, any children’s screenings that were unable to be completed should be screened again. -Any expired medications should be replaced with current medications and returned to parent or disposed of within 72 hours. Other information: • Due to internet connectivity, the visit summary could not be entered during the visit. A copy will be emailed within two business days. •You must notify your consultant 30 days prior to changing the ownership status of your facility • As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. • QRIS Modernization Rulemaking Update-The Office of Administrative Hearings (OAH) published proposed Quality Rating Improvement System (QRIS) Modernization Rules in the North Carolina Register on February 3, 2025., beginning a 60-day public comment period. Interested parties are invited to submit Public Comments on specific rules now through April 4, 2025. A Public Hearing will be held at 1:15 p.m. during the meeting of the North Carolina Child Care Commission on March 26, 2025 in Room 165, 333 Six Forks Road, Raleigh, NC and by WebEx. Sign up instructions and other details will be shared later. The Administrative Procedure Act (G.S. 150B) provides for a uniform procedure for the adoption of rules. Proposed rule changes must progress through several stages of analysis, review, and feedback before becoming effective and entering the state’s Administrative Code. Learn more about participating in the rulemaking process from the Office of Administrative Hearings. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. I will make a follow-up visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis, Child Care Consultant 336-317-5041 jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov Contact information: Phone: 336.551.1130 E-mail: tiffany.eddleman@yadkin.k12.nc.us Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis (Office) 336-317-5041 Jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information, please visit the DCDEE website www.ncchildcare.ncdhhs.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.

G.S. 110-90 · Violation

Name of Operation: FORBUSH PRESCHOOL Facility ID: 99000085 Consultant: JENNIFER DAVIS Operation Type: Center Case Number: Visit Date: 2/13/2025 Number Present: 15 Completed Date: 2/13/2025 Age: From 3 To 5 Total Minutes: 120 Time In: 09:00 AM Time Out: 11:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 , where children participating in the NC Pre-K program are cared for. This visit was conducted by Jennifer Davis, childcare consultant with Tiffany Eddleman, lead teacher. Currently this program operates with a FIVE (5) Star License issued 10/19/17. License restrictions include daytime care only; enhanced ratios minus one; meets enhanced ratios; meets enhanced space. This program is operated by Yadkin County Schools. Currently there is one preschool class with NC Pre-K enrollment. There are full-time and part-time children enrolled in the program. The license was posted, and restrictions were met. The program’s compliance history was 97% prior to today’s visit. All programs are required to maintain at least 75% compliance. The last annual compliance visit was conducted on 2/21/24. A sanitation inspection was completed on 9/11/24 with a Superior classification. A fire inspection was conducted on 9/26/24. All indoor and outdoor areas were observed and monitored during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed the children playing in centers during the visit. I observed positive interactions between staff and children. Storage of hazardous items was monitored. I observed three emergency medications. I observed a DPI off-site transportation form (8/14/24). Program records and required postings were monitored. A fire drill was documented on 1/17/25. A shelter-in-place drill was documented on 11/13/24. A playground inspection was documented on 2/3/25. Staff records were monitored per DCDEE procedure. Children’s records were monitored per DCDEE procedures. DPI offsite verification forms for staff records (8/13/24) and children’s records (8/13/24) were observed. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Tiffany Eddleman, and teacher, Jennifer Sink. Four files were monitored for completed health assessments and developmental screenings. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Teaching Strategies Gold. You stated you were in the process of completing the mid year screenings. The center uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress and documentation was viewed today. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year. The first day of school was August 14, 2024. The classroom operates from 7:30 a.m. to 2:30p.m. Parent conferences are held three times per year. You stated that you use dojo to communicate with parents. In addition, a monthly newsletter is sent home for additional information. You verified that you incorporate family engagement by inviting parents in for special events such as reading and also have family nights in conjunction with the school. Ms. Eddleman stated that there is an open door policy in the classroom for parents. The environment rating scale score received in 2017 was 5.86. The following violations were cited during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One expired medication was not returned to the parent or discarded. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). One staff member had an expired qualification letter. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for one staff member. G.S. 110-90.2(b) & (d) & .2703(e) 1768 The health assessment did not include a hearing screening. One enrolled child did not have a hearing screening on file. .3005 (a)(4) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. COMPLIANCE DOCUMENTATION: You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 2/27/25. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • the name of your center, • facility ID number, • date, • title of the person who signs the letter You may email the letter to jennifer.davis@dhhs.nc.gov If you state in your documentation or report that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Technical assistance provided during today’s visit: -Any staff working in the classroom and the principal should have a current qualification letter on file. -For NC Pre-K screenings, any children’s screenings that were unable to be completed should be screened again. -Any expired medications should be replaced with current medications and returned to parent or disposed of within 72 hours. Other information: • Due to internet connectivity, the visit summary could not be entered during the visit. A copy will be emailed within two business days. •You must notify your consultant 30 days prior to changing the ownership status of your facility • As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. • QRIS Modernization Rulemaking Update-The Office of Administrative Hearings (OAH) published proposed Quality Rating Improvement System (QRIS) Modernization Rules in the North Carolina Register on February 3, 2025., beginning a 60-day public comment period. Interested parties are invited to submit Public Comments on specific rules now through April 4, 2025. A Public Hearing will be held at 1:15 p.m. during the meeting of the North Carolina Child Care Commission on March 26, 2025 in Room 165, 333 Six Forks Road, Raleigh, NC and by WebEx. Sign up instructions and other details will be shared later. The Administrative Procedure Act (G.S. 150B) provides for a uniform procedure for the adoption of rules. Proposed rule changes must progress through several stages of analysis, review, and feedback before becoming effective and entering the state’s Administrative Code. Learn more about participating in the rulemaking process from the Office of Administrative Hearings. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. I will make a follow-up visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis, Child Care Consultant 336-317-5041 jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov Contact information: Phone: 336.551.1130 E-mail: tiffany.eddleman@yadkin.k12.nc.us Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis (Office) 336-317-5041 Jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information, please visit the DCDEE website www.ncchildcare.ncdhhs.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: FORBUSH PRESCHOOL Facility ID: 99000085 Consultant: JENNIFER DAVIS Operation Type: Center Case Number: Visit Date: 2/13/2025 Number Present: 15 Completed Date: 2/13/2025 Age: From 3 To 5 Total Minutes: 120 Time In: 09:00 AM Time Out: 11:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 , where children participating in the NC Pre-K program are cared for. This visit was conducted by Jennifer Davis, childcare consultant with Tiffany Eddleman, lead teacher. Currently this program operates with a FIVE (5) Star License issued 10/19/17. License restrictions include daytime care only; enhanced ratios minus one; meets enhanced ratios; meets enhanced space. This program is operated by Yadkin County Schools. Currently there is one preschool class with NC Pre-K enrollment. There are full-time and part-time children enrolled in the program. The license was posted, and restrictions were met. The program’s compliance history was 97% prior to today’s visit. All programs are required to maintain at least 75% compliance. The last annual compliance visit was conducted on 2/21/24. A sanitation inspection was completed on 9/11/24 with a Superior classification. A fire inspection was conducted on 9/26/24. All indoor and outdoor areas were observed and monitored during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed the children playing in centers during the visit. I observed positive interactions between staff and children. Storage of hazardous items was monitored. I observed three emergency medications. I observed a DPI off-site transportation form (8/14/24). Program records and required postings were monitored. A fire drill was documented on 1/17/25. A shelter-in-place drill was documented on 11/13/24. A playground inspection was documented on 2/3/25. Staff records were monitored per DCDEE procedure. Children’s records were monitored per DCDEE procedures. DPI offsite verification forms for staff records (8/13/24) and children’s records (8/13/24) were observed. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Tiffany Eddleman, and teacher, Jennifer Sink. Four files were monitored for completed health assessments and developmental screenings. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. Your facility uses Teaching Strategies Gold. You stated you were in the process of completing the mid year screenings. The center uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress and documentation was viewed today. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year. The first day of school was August 14, 2024. The classroom operates from 7:30 a.m. to 2:30p.m. Parent conferences are held three times per year. You stated that you use dojo to communicate with parents. In addition, a monthly newsletter is sent home for additional information. You verified that you incorporate family engagement by inviting parents in for special events such as reading and also have family nights in conjunction with the school. Ms. Eddleman stated that there is an open door policy in the classroom for parents. The environment rating scale score received in 2017 was 5.86. The following violations were cited during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One expired medication was not returned to the parent or discarded. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). One staff member had an expired qualification letter. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for one staff member. G.S. 110-90.2(b) & (d) & .2703(e) 1768 The health assessment did not include a hearing screening. One enrolled child did not have a hearing screening on file. .3005 (a)(4) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. COMPLIANCE DOCUMENTATION: You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 2/27/25. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • the name of your center, • facility ID number, • date, • title of the person who signs the letter You may email the letter to jennifer.davis@dhhs.nc.gov If you state in your documentation or report that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Technical assistance provided during today’s visit: -Any staff working in the classroom and the principal should have a current qualification letter on file. -For NC Pre-K screenings, any children’s screenings that were unable to be completed should be screened again. -Any expired medications should be replaced with current medications and returned to parent or disposed of within 72 hours. Other information: • Due to internet connectivity, the visit summary could not be entered during the visit. A copy will be emailed within two business days. •You must notify your consultant 30 days prior to changing the ownership status of your facility • As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. • QRIS Modernization Rulemaking Update-The Office of Administrative Hearings (OAH) published proposed Quality Rating Improvement System (QRIS) Modernization Rules in the North Carolina Register on February 3, 2025., beginning a 60-day public comment period. Interested parties are invited to submit Public Comments on specific rules now through April 4, 2025. A Public Hearing will be held at 1:15 p.m. during the meeting of the North Carolina Child Care Commission on March 26, 2025 in Room 165, 333 Six Forks Road, Raleigh, NC and by WebEx. Sign up instructions and other details will be shared later. The Administrative Procedure Act (G.S. 150B) provides for a uniform procedure for the adoption of rules. Proposed rule changes must progress through several stages of analysis, review, and feedback before becoming effective and entering the state’s Administrative Code. Learn more about participating in the rulemaking process from the Office of Administrative Hearings. At the completion of the visit, this visit summary was reviewed with and provided to you. Thank you for your time and assistance during the visit. I will make a follow-up visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis, Child Care Consultant 336-317-5041 jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov Contact information: Phone: 336.551.1130 E-mail: tiffany.eddleman@yadkin.k12.nc.us Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis (Office) 336-317-5041 Jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information, please visit the DCDEE website www.ncchildcare.ncdhhs.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: FORBUSH PRESCHOOL Facility ID: 99000085 Consultant: JENNIFER DAVIS Operation Type: Center Case Number: Visit Date: 9/18/2024 Number Present: 16 Completed Date: 9/18/2024 Age: From 3 To 5 Total Minutes: 105 Time In: 09:15 AM Time Out: 11:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's routine unannounced visit was to monitor compliance with applicable child care requirements at this licensed program. This visit was conducted by Jennifer Davis, child care consultant with Tiffany Eddleman, lead teacher. Currently this program operates with FIVE (5) star license issued 10/19/17. Restrictions include daytime care only; meets enhance space; meets enhanced ratios; meets enhanced ratios minus one. The license was observed, and the restrictions were met. Twenty-three(23) children, ages 3 to 5, are currently enrolled. Sixteen(16) children, ages 3 to 5, were present today. Ms. Eddleman stated that there are children that come part-time and that no more than 18 are present at any one time. This program is operated by Yadkin County Schools and currently has children enrolled in NC Pre-K. Today, the following items were monitored: • Supervision • S/C Ratios • CPR-expires 4/19/26 • First Aid-expires 4/19/26 • Special Training • CRC Completed • It’s SIDS Training-N/A • Emergency Medical Care Plan • Administering Medication • Storage of Hazardous Substances • Storage of Medication • General Safety • Discipline • Adequate/Approved Space • Program Records • License Posted • Permit Restrictions A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed positive interactions today. During the visit, the children were engaged in center free play and music. No new staff were reported at this program. Storage and administration of medication were monitored. Medication authorization was monitored. Three emergency medications was observed. Storage hazardous items was monitored today. A playground inspection was recorded 8/13/24. A fire drill was recorded 9/5/24. A lock down drill was recorded 9/10/24. The most recent fire inspection was on 2/7/24. A sanitation inspection was last conducted on 4/21/23 earning a superior classification. YCS does currently provide transportation for two students enrolled in the PreK program. The program’s compliance history was 97% prior to today’s visit. All programs are required to maintain at least 75% compliance. The following violation was cited today. Violation Number Comment Rule 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Two children did not have permission for routine transportation on file. .1003(i)(j) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. If you report or state in your documentation that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. COMPLIANCE DOCUMENTATION: You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 10/2/24. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • the name of your center, • facility ID number, • date, • title of the person who signs the letter You may email the letter to jennifer.davis@dhhs.nc.gov If you state in your documentation or report that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance or failure to submit the corrective action plan prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable child care requirements. Technical assistance provided during today’s visit: • We went over transportation forms today. A permission to transport form was emailed during the visit. The form should be on file for routine transportation as well as individual field trips. Additional Information: -During the visit we discussed transcripts should be on file for early childhood coursework for in-service training hours. Contact information: Phone: 336.551.1130 E-mail: tiffany.eddleman@yadkin.k12.nc.us At the completion of the visit, this visit summary was reviewed with the provider and emailed to the provider. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis (Office) 336-317-5041 Jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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.

NC GS 110-90 · Violation

Name of Operation: FORBUSH PRESCHOOL Facility ID: 99000085 Consultant: JENNIFER DAVIS Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 16 Completed Date: 2/21/2024 Age: From 3 To 6 Total Minutes: 100 Time In: 09:05 AM Time Out: 10:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this licensed program to monitor compliance with applicable child care requirements. This visit was conducted by Jennifer Davis, child care consultant with Tiffany Eddleman, lead teacher. Currently this program operates with a FIVE (5) Star License issued 10/19/17. License restrictions include daytime care only; enhanced ratios minus one; meets enhanced ratios; meets enhanced space. This program is operated by Yadkin County Schools. Currently there is one preschool class with enrollment. The class is not designed NCPK. There are full-time and part-time children enrolled in the program. The license was posted, and restrictions were met. The program’s compliance history was 98% prior to today’s visit. All programs are required to maintain at least 75% compliance. The last annual compliance visit was conducted on 3/22/23. A sanitation inspection was completed on 1/30/24 with a Superior classification. A fire inspection was conducted on 2/7/24. All indoor and outdoor areas were observed and monitored during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed the children playing in centers during the visit. I observed positive interactions between staff and children. Storage of hazardous items was monitored. I observed one emergency medication. I observed a DPI off-site transportation form (8/11/23). Program records and required postings were monitored. A fire drill was documented on 1/30/24. A shelter-in-place drill was documented on 12/11/23. A playground inspection was documented on 2/2/24. Staff records were monitored per DCDEE procedure. Children’s records were monitored per DCDEE procedures. DPI offsite verification forms for staff records (8/16/23) and children’s records (8/16/23) were observed. The following violations were cited during the visit: Violation Number Comment Rule 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One staff person did not have an updated emergency form on file. .0701(a) 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 member did not renew the medication in child care training topic. .1103(b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. COMPLIANCE DOCUMENTATION: You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 3/6/24. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • the name of your center, • facility ID number, • date, • title of the person who signs the letter You may email the letter to jennifer.davis@dhhs.nc.gov If you state in your documentation or report that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Technical assistance provided during today’s visit: -The emergency forms and health questionnaires should be updated annually for each staff member. - The medication training that needs to be renewed every five years is in Moodle on the DCDEE website. Other information: • All rated license will continue to be in hold harmless state until 6/2024. Your program is in Cohort 1 so you will request the ERS in the 2023-24 school year since you do not want to participate in the prep year assessment. Check the www.ncrlap.org website for updated ERS resources. Contact information: Phone: 336.551.1130 E-mail: tiffany.eddleman@yadkin.k12.nc.us The visit summary and enrollment worksheet were completed during the visit and a copy was emailed to the provider. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis (Office) 336-317-5041 Jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information, please visit the DCDEE website www.ncchildcare.ncdhhs.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.

NC GS 110-90 · Violation

Name of Operation: FORBUSH PRESCHOOL Facility ID: 99000085 Consultant: JENNIFER DAVIS Operation Type: Center Case Number: Visit Date: 9/19/2023 Number Present: 16 Completed Date: 9/19/2023 Age: From 3 To 5 Total Minutes: 95 Time In: 09:25 AM Time Out: 11:00 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's routine unannounced visit was to monitor compliance with applicable child care requirements at this licensed program. This visit was conducted by Jennifer Davis, child care consultant with Tiffany Eddleman, lead teacher. Currently this program operates with FIVE (5) star license issued 10/19/17. Restrictions include daytime care only; meets enhance space; meets enhanced ratios; meets enhanced ratios minus one. The license was observed, and the restrictions were met. Twenty-three(23) children, ages 3 to 5, are currently enrolled. Sixteen(16) children, ages 3 to 5, were present today. Ms. Eddleman stated that there are children that come part-time and that no more than 18 are present at any one time. This program is operated by Yadkin County Schools and is not designated NCPK. Today, the following items were monitored: • Supervision • S/C Ratios • CPR • First Aid • Special Training • CRC Completed • It’s SIDS Training • Emergency Medical Care Plan • Administering Medication • Storage of Hazardous Substances • Storage of Medication • General Safety • Discipline • Adequate/Approved Space • Program Records • License Posted • Permit Restrictions A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed positive interactions today. During the visit, the children were engaged in center free play and music. One new staff was reported at this program. She came from another preschool site in Yadkin County and was current on CBC, CPR/First Aid, and Health and Safety trainings. The snack today was goldfish and milk. Storage and administration of medication were monitored. Medication authorization was monitored. One emergency medications was observed. Storage hazardous items was monitored today. A playground inspection was recorded 8/15/23. A fire drill was recorded 8/21/23. A lock down drill was recorded 8/31/23. The most recent fire inspection was on 10/22/22. A sanitation inspection was last conducted on 4/21/23 earning a superior classification. YCS does currently provide transportation for one student enrolled in the PreK program. The program’s compliance history was 96% prior to today’s visit. All programs are required to maintain at least 75% compliance. The following violations were cited today. Violation Number Comment Rule 1867 The depth of the loose surfacing was not based on critical height of the equipment.The depth of the mulch within the fall zone of the stationary play equipment measured less than 6 inches deep. .0605(k)(1-4) 9995 15A NCAC 18A .2832 OUTDOOR LEARNING ENVIRONMENT AND PREMISES (a) At child care centers, the premises, including the outdoor learning environment, shall be kept clean, drained to minimize standing water, free of litter and hazardous materials, and maintained in a manner which does not encourage the harborage of vermin. The outdoor playset was visibly dirty and needs to be cleaned. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. If you report or state in your documentation that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. COMPLIANCE DOCUMENTATION: You must correct the violation cited during today's visit immediately and send me documentation verifying compliance on or before 10/3/23. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • the name of your center, • facility ID number, • date, • title of the person who signs the letter You may email the letter to jennifer.davis@dhhs.nc.gov If you state in your documentation or report that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. Repeated violations, continued non-compliance or failure to submit the corrective action plan prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable child care requirements. Technical assistance provided during today’s visit: • We discussed rated license information during the visit. You are in Cohort 1 for the rated license reassessment. We discussed training requirements for health and safety and hours. Contact information: Phone: 336.551.1130 E-mail: tiffany.eddleman@yadkin.k12.nc.us At the completion of the visit, this visit summary was reviewed with the provider and emailed to the provider. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Jennifer Davis (Office) 336-317-5041 Jennifer.davis@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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.