10A NCAC 09 .0102 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: UPWARD PSAM-PSPM-PLUS Facility ID: 45000031 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/20/2024 Number Present: 9 Completed Date: 3/20/2024 Age: From 5 To 8 Total Minutes: 125 Time In: 02:55 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Upon arrival, I checked in at the front office and walked down to gym. Once I arrived in the gym, Sara Brown, Director greeted me. Ms. Brown was available during the visit. The program operates with a Five (5) Star Rated License, issued 12/31/2018. The permit restrictions were in compliance including school age only, meets reduced group size by one (1) from seven (7) point; Playground does not meet NC child care playground safety standards; meets enhanced space. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The last annual compliance visit was conducted on 3/28/2023. The last fire drill was practiced on 3/12/2024. The last lockdown drill was practiced on 2/8/2024. The last fire inspection was approved on 8/17/2023. The last sanitation inspection was conducted on 2/26/2023 with six (6) demerits for a superior classification. The last lead testing 6/1/2022. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plans was updated and reviewed on 8/11/2023. Currently, the program has no medications for the children enrolled. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-nine percent (99%) as of 3/20/2024. During the visit, the students ages five to eight years old began arriving in the gym at 2:57p and putting their belongings in their individual basket. After putting their belongings away, the children looked at books in front of the stage. When the children were done looking at books, they began to play duck duck goose in the middle of the gym. At 3:22p one (1) staff member left to go to the cafeteria to clean the tables and prepare for snack. The other staff member remained in the gym with the children. At 3:28p the children lined up to transition to the restroom to wash hands. After washing hands in the restroom, the children transitioned to the cafeteria for snack. Snack consisted of Bug Bites graham crackers and milk. During snack, the kitchen door was observed opened making the hot water accessible to children. The children finished snack and lined up to transition back to the restroom to wash hands and transition outdoors for gross motor play. Once outside, the children engaged in play with the climber, swings, balls, chalk, and musical instruments. The program does not provide transportation. Staff and children’s files were monitored during the visit. I monitored one (1) new staff, and one (1) existing staff file was monitored. The staff and training worksheet was received prior to today's visit. Staff file concerns: IR hired with PSPM on 1/24/2022 and moved to Upward PSPM on 3/12/2024 had a medical report on file dated 3/28/2011. The medical report was older than twelve (12) months prior to hire date with the PSPM program. I monitored two (2) children’s files and completed the Children’s Record form. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. 10A NCAC 09 .0701(a) 9995 A violation was found for which there is no item number. In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. Technical assistance was provided as follows: Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member IP hired 1/24/2022 with the PSPM program and moved to Upward PSPM on 3/13/2024 medical report on file was older than twelve (12) months. The medical report on file was dated 3/28/2011. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #9995 A violation was found for which there is no item number. Hot water in excess to 120 degrees was accessible to children. 15A NCAC 18A .2815 WATER SUPPLY (e) Hot water used for cleaning and sanitizing food utensils and laundry shall be provided at a minimum temperature of 120°F (49°C) at the point of use. Water in areas accessible to children shall be tempered between 80°F (27°C) and 110°F (43°C). For hand wash lavatories used exclusively by school-age children, the 80°F (27°C) minimum temperature requirement shall not apply. Hot water in an area accessible to any child, which is in excess of 120°F (49°C), shall be considered a burn hazard. Child care centers serving only school-age children are not required to provide hot water in areas accessible to children. In the event of the loss of hot water, the person in charge shall immediately contact the local health department. - In the cafeteria, the kitchen door was left open making the hot water in excess to 120 degrees accessible to the children enrolled. I suggest shutting the door each time you go in and out of the kitchen in order to not make the hot water accessible to children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/3/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: We discussed that you are a part of Cohort 1 for rated license reassessments. The program’s year of preparation will begin 7/1/2023 and end 6/30/2024. The assessment year will begin 7/1/2024 and end 6/30/2025. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. The benefits of taking advantage of the preparation year assessment are: the scores do not have to count, assessment results can help build understanding of the current program situations, and programs. Remind the children to scrub their hands with soap and water during each hand washing. Hand sanitizer does not take the place of hand washing if soap and water is accessible. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Sara Brown, Director, during the visit. An electronic signed copy of the visit summary was left on-site with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times