10A NCAC 09 .0713 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0525-304L Visit Date: 6/5/2025 Number Present: 36 Completed Date: 6/5/2025 Age: From 1 To 5 Total Minutes: 255 Time In: 10:00 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by The Division of Child Development and Early Education (DCDEE) on 5/27/25 and by Dawn McCrary, 5/27/25. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Kevin Monroe, Owner. A signed copy of the visit summary was left on-site for you. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 6/4/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. There are allegations of violations of child care requirements. There are concerns that: The staff to child ratio for 1-year-old children is 1:12 during the day. The indoor space that is used for activities when the weather is bad is very small for the twenty children occupying it. Upon my arrival, I made my presence known to Kevin Monroe, Owner, and explained the reason for my visit. Mr. Monroe was available to assist during the visit. The facility was monitored for staff/child ratios. Space #5 was occupied by nine (9) one (1) year old's and one (1) two (2) year old with two (2) caregivers. Space #4 was occupied by seven (7) two (2) year old's and three (3) year old's with one caregiver. Space #3 was not in use. Space #2 was occupied by four (4) three (3) year old's and six (6) four years old's with one caregiver. Space #1 was occupied by five (5) four (4) year old's and one (1) five (5) year old with one caregiver. Each classroom had staff/child ratio that was meeting child care requirements. Regarding the concern of the staff to child ratio for one-year-old children: Per 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS, the staff/child ratio for 12 to 24 months is 1/6 with a maximum group size of 12. This part of the concern is unsubstantiated. I asked Mr. Monroe which space was used for activities when there is inclement weather. Mr. Monroe identified the space. Mr. Monroe stated that the space is occupied by individual classrooms during inclement weather based on each classroom’s outdoor time on the schedule. It also has been used to combine the children in the last operating hour of the day. The staff/child ratio for the youngest child in the group is maintained for the entire group. Upon review of the facility’s building inspection, DCDEE approved space calculations, and floor plan, it was determined that the space Mr. Monroe identified as the inclement weather indoor space, is not approved caregiving space. Mr. Monroe was unaware that the inclement weather space was not an approved caregiving space. Mr. Monroe stated that the space will remain unused for the care of children until a building, fire, and sanitation inspection for the space is conducted and the space is measured and approved by DCDEE. Regarding the concern of the indoor space that is used for activities when the weather is bad is very small for the twenty children occupying it: Based on my observations and interview, there is no evidence of the space being DCDEE approved for caregiving. Therefore, the maximum number of children in the space is unknown. This part of the concern is unsubstantiated. However, due to the unapproved space being used for caregiving in the past, a violation of the use of unapproved space was documented during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit Violation Number Comment Rule 209 Children used space that was not approved. The space reported to be used for gross motor activity during inclement weather is not approved caregiving space. GS 110-91(1)&(4-5) Technical assistance provided as follows: 209 § 110-91. Mandatory standards for a license. (4) Building. – Each child care facility shall be located in a building which meets the appropriate requirements of the North Carolina Building Code under standards which shall be developed by the Building Code Council, subject to adoption by the Commission specifically for child care facilities, including facilities operated in a private residence. These standards shall be consistent with the provisions of this Article. A local building code enforcement officer shall approve any proposed alternate material, design, or method of construction, provided the building code enforcement officer finds that the alternate, for the purpose intended, is at least the equivalent of that prescribed in the technical building codes in quality, strength, effectiveness, fire resistance, durability, or safety. A local building code enforcement officer shall require that sufficient evidence or proof be submitted to substantiate any claim made regarding the alternate. The Child Care Commission may request changes to the Building Code to suit the special needs of preschool children. Satisfactorily written reports from representatives of building inspection agencies shall be required prior to the issuance of a license and whenever renovations are made to a child care center, or when the operator requests licensure of space not previously approved for child care. The space reported to be used for gross motor activity during inclement weather is not approved caregiving space. Achieving Compliance: A follow-up visit will be conducted to verify compliance of violation # 209 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 6/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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.

GS 110-91 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0525-304L Visit Date: 6/5/2025 Number Present: 36 Completed Date: 6/5/2025 Age: From 1 To 5 Total Minutes: 255 Time In: 10:00 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by The Division of Child Development and Early Education (DCDEE) on 5/27/25 and by Dawn McCrary, 5/27/25. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Kevin Monroe, Owner. A signed copy of the visit summary was left on-site for you. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 6/4/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. There are allegations of violations of child care requirements. There are concerns that: The staff to child ratio for 1-year-old children is 1:12 during the day. The indoor space that is used for activities when the weather is bad is very small for the twenty children occupying it. Upon my arrival, I made my presence known to Kevin Monroe, Owner, and explained the reason for my visit. Mr. Monroe was available to assist during the visit. The facility was monitored for staff/child ratios. Space #5 was occupied by nine (9) one (1) year old's and one (1) two (2) year old with two (2) caregivers. Space #4 was occupied by seven (7) two (2) year old's and three (3) year old's with one caregiver. Space #3 was not in use. Space #2 was occupied by four (4) three (3) year old's and six (6) four years old's with one caregiver. Space #1 was occupied by five (5) four (4) year old's and one (1) five (5) year old with one caregiver. Each classroom had staff/child ratio that was meeting child care requirements. Regarding the concern of the staff to child ratio for one-year-old children: Per 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS, the staff/child ratio for 12 to 24 months is 1/6 with a maximum group size of 12. This part of the concern is unsubstantiated. I asked Mr. Monroe which space was used for activities when there is inclement weather. Mr. Monroe identified the space. Mr. Monroe stated that the space is occupied by individual classrooms during inclement weather based on each classroom’s outdoor time on the schedule. It also has been used to combine the children in the last operating hour of the day. The staff/child ratio for the youngest child in the group is maintained for the entire group. Upon review of the facility’s building inspection, DCDEE approved space calculations, and floor plan, it was determined that the space Mr. Monroe identified as the inclement weather indoor space, is not approved caregiving space. Mr. Monroe was unaware that the inclement weather space was not an approved caregiving space. Mr. Monroe stated that the space will remain unused for the care of children until a building, fire, and sanitation inspection for the space is conducted and the space is measured and approved by DCDEE. Regarding the concern of the indoor space that is used for activities when the weather is bad is very small for the twenty children occupying it: Based on my observations and interview, there is no evidence of the space being DCDEE approved for caregiving. Therefore, the maximum number of children in the space is unknown. This part of the concern is unsubstantiated. However, due to the unapproved space being used for caregiving in the past, a violation of the use of unapproved space was documented during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit Violation Number Comment Rule 209 Children used space that was not approved. The space reported to be used for gross motor activity during inclement weather is not approved caregiving space. GS 110-91(1)&(4-5) Technical assistance provided as follows: 209 § 110-91. Mandatory standards for a license. (4) Building. – Each child care facility shall be located in a building which meets the appropriate requirements of the North Carolina Building Code under standards which shall be developed by the Building Code Council, subject to adoption by the Commission specifically for child care facilities, including facilities operated in a private residence. These standards shall be consistent with the provisions of this Article. A local building code enforcement officer shall approve any proposed alternate material, design, or method of construction, provided the building code enforcement officer finds that the alternate, for the purpose intended, is at least the equivalent of that prescribed in the technical building codes in quality, strength, effectiveness, fire resistance, durability, or safety. A local building code enforcement officer shall require that sufficient evidence or proof be submitted to substantiate any claim made regarding the alternate. The Child Care Commission may request changes to the Building Code to suit the special needs of preschool children. Satisfactorily written reports from representatives of building inspection agencies shall be required prior to the issuance of a license and whenever renovations are made to a child care center, or when the operator requests licensure of space not previously approved for child care. The space reported to be used for gross motor activity during inclement weather is not approved caregiving space. Achieving Compliance: A follow-up visit will be conducted to verify compliance of violation # 209 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 6/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0525-304L Visit Date: 6/5/2025 Number Present: 36 Completed Date: 6/5/2025 Age: From 1 To 5 Total Minutes: 255 Time In: 10:00 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by The Division of Child Development and Early Education (DCDEE) on 5/27/25 and by Dawn McCrary, 5/27/25. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Kevin Monroe, Owner. A signed copy of the visit summary was left on-site for you. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 6/4/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. There are allegations of violations of child care requirements. There are concerns that: The staff to child ratio for 1-year-old children is 1:12 during the day. The indoor space that is used for activities when the weather is bad is very small for the twenty children occupying it. Upon my arrival, I made my presence known to Kevin Monroe, Owner, and explained the reason for my visit. Mr. Monroe was available to assist during the visit. The facility was monitored for staff/child ratios. Space #5 was occupied by nine (9) one (1) year old's and one (1) two (2) year old with two (2) caregivers. Space #4 was occupied by seven (7) two (2) year old's and three (3) year old's with one caregiver. Space #3 was not in use. Space #2 was occupied by four (4) three (3) year old's and six (6) four years old's with one caregiver. Space #1 was occupied by five (5) four (4) year old's and one (1) five (5) year old with one caregiver. Each classroom had staff/child ratio that was meeting child care requirements. Regarding the concern of the staff to child ratio for one-year-old children: Per 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS, the staff/child ratio for 12 to 24 months is 1/6 with a maximum group size of 12. This part of the concern is unsubstantiated. I asked Mr. Monroe which space was used for activities when there is inclement weather. Mr. Monroe identified the space. Mr. Monroe stated that the space is occupied by individual classrooms during inclement weather based on each classroom’s outdoor time on the schedule. It also has been used to combine the children in the last operating hour of the day. The staff/child ratio for the youngest child in the group is maintained for the entire group. Upon review of the facility’s building inspection, DCDEE approved space calculations, and floor plan, it was determined that the space Mr. Monroe identified as the inclement weather indoor space, is not approved caregiving space. Mr. Monroe was unaware that the inclement weather space was not an approved caregiving space. Mr. Monroe stated that the space will remain unused for the care of children until a building, fire, and sanitation inspection for the space is conducted and the space is measured and approved by DCDEE. Regarding the concern of the indoor space that is used for activities when the weather is bad is very small for the twenty children occupying it: Based on my observations and interview, there is no evidence of the space being DCDEE approved for caregiving. Therefore, the maximum number of children in the space is unknown. This part of the concern is unsubstantiated. However, due to the unapproved space being used for caregiving in the past, a violation of the use of unapproved space was documented during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violation was documented during today’s visit Violation Number Comment Rule 209 Children used space that was not approved. The space reported to be used for gross motor activity during inclement weather is not approved caregiving space. GS 110-91(1)&(4-5) Technical assistance provided as follows: 209 § 110-91. Mandatory standards for a license. (4) Building. – Each child care facility shall be located in a building which meets the appropriate requirements of the North Carolina Building Code under standards which shall be developed by the Building Code Council, subject to adoption by the Commission specifically for child care facilities, including facilities operated in a private residence. These standards shall be consistent with the provisions of this Article. A local building code enforcement officer shall approve any proposed alternate material, design, or method of construction, provided the building code enforcement officer finds that the alternate, for the purpose intended, is at least the equivalent of that prescribed in the technical building codes in quality, strength, effectiveness, fire resistance, durability, or safety. A local building code enforcement officer shall require that sufficient evidence or proof be submitted to substantiate any claim made regarding the alternate. The Child Care Commission may request changes to the Building Code to suit the special needs of preschool children. Satisfactorily written reports from representatives of building inspection agencies shall be required prior to the issuance of a license and whenever renovations are made to a child care center, or when the operator requests licensure of space not previously approved for child care. The space reported to be used for gross motor activity during inclement weather is not approved caregiving space. Achieving Compliance: A follow-up visit will be conducted to verify compliance of violation # 209 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 6/19/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/2/2025 Number Present: 51 Completed Date: 4/2/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Erin, Betz, Administrator, during the visit. A signed copy of the visit summary was left on site for your records. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 4/2/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. Upon arrival, I made my presence known to Erin Betz, Administrator. Ms. Betz was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were having free choice play in the classrooms having routine care, and transitioning to lunch. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. This program does not provide transportation. The Clean Water for US Kids website was monitored. You have started the enrollment process for lead based paint and asbestos. You have completed the lead in water analysis. 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 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One feeding plan for child, R.C. did not include a parent signature. .0902(a) Technical assistance provided as follows: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS One feeding plan for child, R.C. did not include a parent signature. You stated that you plan to have the parent sign the feeding plan at pick up today. Due to Tropical Storm Helene and the State of Emergency, additional time was allowed for the facility to receive a fire inspection. The previous fire inspection was conducted 10/5/23, the most recent fire inspection was conducted 12/9/24. The facility had reached out to the Fire Marshal's office several times, as early as May of 2024 to schedule the inspection. Achieving compliance All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/16/25. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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 .0902 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/2/2025 Number Present: 51 Completed Date: 4/2/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Erin, Betz, Administrator, during the visit. A signed copy of the visit summary was left on site for your records. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 4/2/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. Upon arrival, I made my presence known to Erin Betz, Administrator. Ms. Betz was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were having free choice play in the classrooms having routine care, and transitioning to lunch. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. This program does not provide transportation. The Clean Water for US Kids website was monitored. You have started the enrollment process for lead based paint and asbestos. You have completed the lead in water analysis. 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 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One feeding plan for child, R.C. did not include a parent signature. .0902(a) Technical assistance provided as follows: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS One feeding plan for child, R.C. did not include a parent signature. You stated that you plan to have the parent sign the feeding plan at pick up today. Due to Tropical Storm Helene and the State of Emergency, additional time was allowed for the facility to receive a fire inspection. The previous fire inspection was conducted 10/5/23, the most recent fire inspection was conducted 12/9/24. The facility had reached out to the Fire Marshal's office several times, as early as May of 2024 to schedule the inspection. Achieving compliance All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/16/25. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/2/2025 Number Present: 51 Completed Date: 4/2/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Erin, Betz, Administrator, during the visit. A signed copy of the visit summary was left on site for your records. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 4/2/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. Upon arrival, I made my presence known to Erin Betz, Administrator. Ms. Betz was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were having free choice play in the classrooms having routine care, and transitioning to lunch. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. This program does not provide transportation. The Clean Water for US Kids website was monitored. You have started the enrollment process for lead based paint and asbestos. You have completed the lead in water analysis. 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 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One feeding plan for child, R.C. did not include a parent signature. .0902(a) Technical assistance provided as follows: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS One feeding plan for child, R.C. did not include a parent signature. You stated that you plan to have the parent sign the feeding plan at pick up today. Due to Tropical Storm Helene and the State of Emergency, additional time was allowed for the facility to receive a fire inspection. The previous fire inspection was conducted 10/5/23, the most recent fire inspection was conducted 12/9/24. The facility had reached out to the Fire Marshal's office several times, as early as May of 2024 to schedule the inspection. Achieving compliance All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/16/25. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/2/2025 Number Present: 51 Completed Date: 4/2/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Erin, Betz, Administrator, during the visit. A signed copy of the visit summary was left on site for your records. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 4/2/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. Upon arrival, I made my presence known to Erin Betz, Administrator. Ms. Betz was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were having free choice play in the classrooms having routine care, and transitioning to lunch. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. This program does not provide transportation. The Clean Water for US Kids website was monitored. You have started the enrollment process for lead based paint and asbestos. You have completed the lead in water analysis. 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 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One feeding plan for child, R.C. did not include a parent signature. .0902(a) Technical assistance provided as follows: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS One feeding plan for child, R.C. did not include a parent signature. You stated that you plan to have the parent sign the feeding plan at pick up today. Due to Tropical Storm Helene and the State of Emergency, additional time was allowed for the facility to receive a fire inspection. The previous fire inspection was conducted 10/5/23, the most recent fire inspection was conducted 12/9/24. The facility had reached out to the Fire Marshal's office several times, as early as May of 2024 to schedule the inspection. Achieving compliance All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/16/25. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/2/2025 Number Present: 51 Completed Date: 4/2/2025 Age: From 0 To 5 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Erin, Betz, Administrator, during the visit. A signed copy of the visit summary was left on site for your records. The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 4/2/25. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. Upon arrival, I made my presence known to Erin Betz, Administrator. Ms. Betz was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were having free choice play in the classrooms having routine care, and transitioning to lunch. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. This program does not provide transportation. The Clean Water for US Kids website was monitored. You have started the enrollment process for lead based paint and asbestos. You have completed the lead in water analysis. 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 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. One feeding plan for child, R.C. did not include a parent signature. .0902(a) Technical assistance provided as follows: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS One feeding plan for child, R.C. did not include a parent signature. You stated that you plan to have the parent sign the feeding plan at pick up today. Due to Tropical Storm Helene and the State of Emergency, additional time was allowed for the facility to receive a fire inspection. The previous fire inspection was conducted 10/5/23, the most recent fire inspection was conducted 12/9/24. The facility had reached out to the Fire Marshal's office several times, as early as May of 2024 to schedule the inspection. Achieving compliance All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/16/25. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/25/2024 Number Present: 40 Completed Date: 7/25/2024 Age: From 0 To 5 Total Minutes: 235 Time In: 09:50 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit. A signed copy of the visit summary was left on-site for you. Today, the Administrator, Erin Betz, accompanied me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-seven (97) percentage as of 07/24/2024 The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Learning Tree LLC, is current/active as of 07/24/2024. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/3/23. The last fire drill was practiced on 6/10/24. The last lockdown drill was practiced on 5/23/24. The last playground inspection was documented on 6/11/24. The last fire inspection was approved on 10/5/23. The last sanitation inspection was conducted on 1/12/24 with three (3) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The EPR plan was updated 5/29/24. Upon arrival I introduced my presence to the Administrator, Erin Betz. I observed the group with three- to five-year-old children engaged in an art activity. The infants were being fed, interacting with the caregiver and having routine care. The one-year-old children were participating in routine care and eating. The two-year-olds were participating in free choice play and toilet training. The classroom for three-year-olds was temporarily closed. The outdoor learning environment offers adequate space for running and vigorous play with wheeled toys, balls and portable materials to enhance play. All interactions were positive, supervision was adequate. The staff and training worksheets were received prior to today's visit and were monitored for child care requirements. There is one (1) newly hired staff and seven (7) existing staff. The newly hired staff’s file and one (1) existing staff’s file was monitored during the visit. There are fifty-three (53) children enrolled. Five (5) child files were monitored during the visit. 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 program does not provide transportation. The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted in space #5. GS 110-91(12); .0508(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol sunscreen was in unlocked storage in space #3. .2820(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. ne (1) newly hired staff, K.W. did not have signed acknowledgement of the facility's shaken baby syndrome policy on file. .0608(d)(1-4) Technical assistance provided: 1874-The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. 428-A current activity plan was not posted for each group of children for reference. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. A current activity plan was not posted in space #5. A current activity plan was posted during the visit for correction. No further action is required. 840-All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. An aerosol sunscreen was in unlocked storage in space #3. The aerosol sunscreen was moved to locked storage during the visit for correction. No further action is required. Plan to review proper storage of materials with all staff. Consultation is provided as follows: We discussed the Emergency Preparedness Training section of the staff and training worksheet. We discussed a process to streamline staff files regarding signed acknowledgement of polices received. The U.S. Consumer Product Safety Commission has recalled a few items. I’ve provided you with a description of the recalled products and a link summarizing the recall and associated product. Please share with the families you serve. Power Adapters Sold with Rest 1st Generation Sound Machines: Power: https://www.cpsc.gov/Recalls/2024/Hatch-Baby-Recalls-Power-Adapters-Sold-with-Rest-1st-Generation-Sound-Machines-Due-to-Shock-Hazard Theefun Kids Gardening Tool Sets: https://www.cpsc.gov/Recalls/2024/Thousandshores-Recalled-Theefun-Kids-Gardening-Tools-Sets-Due-to-Violation-of-the-Federal-Phthalates-Ban-Sold-Exclusively-on-Amazon Sling Carriers: https://www.cpsc.gov/Recalls/2024/Sling-Carriers-Recalled-Due-to-Infant-Suffocation-and-Fall-Hazards-Violation-of-the-Federal-Safety-Regulation-for-Sling-Carriers-Sold-on-Walmart-com-through-Joybuy-Marketplace-Express Children’s Pajama Sets: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online Children’s Nightgowns: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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 .0508 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/25/2024 Number Present: 40 Completed Date: 7/25/2024 Age: From 0 To 5 Total Minutes: 235 Time In: 09:50 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit. A signed copy of the visit summary was left on-site for you. Today, the Administrator, Erin Betz, accompanied me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-seven (97) percentage as of 07/24/2024 The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Learning Tree LLC, is current/active as of 07/24/2024. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/3/23. The last fire drill was practiced on 6/10/24. The last lockdown drill was practiced on 5/23/24. The last playground inspection was documented on 6/11/24. The last fire inspection was approved on 10/5/23. The last sanitation inspection was conducted on 1/12/24 with three (3) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The EPR plan was updated 5/29/24. Upon arrival I introduced my presence to the Administrator, Erin Betz. I observed the group with three- to five-year-old children engaged in an art activity. The infants were being fed, interacting with the caregiver and having routine care. The one-year-old children were participating in routine care and eating. The two-year-olds were participating in free choice play and toilet training. The classroom for three-year-olds was temporarily closed. The outdoor learning environment offers adequate space for running and vigorous play with wheeled toys, balls and portable materials to enhance play. All interactions were positive, supervision was adequate. The staff and training worksheets were received prior to today's visit and were monitored for child care requirements. There is one (1) newly hired staff and seven (7) existing staff. The newly hired staff’s file and one (1) existing staff’s file was monitored during the visit. There are fifty-three (53) children enrolled. Five (5) child files were monitored during the visit. 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 program does not provide transportation. The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted in space #5. GS 110-91(12); .0508(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol sunscreen was in unlocked storage in space #3. .2820(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. ne (1) newly hired staff, K.W. did not have signed acknowledgement of the facility's shaken baby syndrome policy on file. .0608(d)(1-4) Technical assistance provided: 1874-The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. 428-A current activity plan was not posted for each group of children for reference. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. A current activity plan was not posted in space #5. A current activity plan was posted during the visit for correction. No further action is required. 840-All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. An aerosol sunscreen was in unlocked storage in space #3. The aerosol sunscreen was moved to locked storage during the visit for correction. No further action is required. Plan to review proper storage of materials with all staff. Consultation is provided as follows: We discussed the Emergency Preparedness Training section of the staff and training worksheet. We discussed a process to streamline staff files regarding signed acknowledgement of polices received. The U.S. Consumer Product Safety Commission has recalled a few items. I’ve provided you with a description of the recalled products and a link summarizing the recall and associated product. Please share with the families you serve. Power Adapters Sold with Rest 1st Generation Sound Machines: Power: https://www.cpsc.gov/Recalls/2024/Hatch-Baby-Recalls-Power-Adapters-Sold-with-Rest-1st-Generation-Sound-Machines-Due-to-Shock-Hazard Theefun Kids Gardening Tool Sets: https://www.cpsc.gov/Recalls/2024/Thousandshores-Recalled-Theefun-Kids-Gardening-Tools-Sets-Due-to-Violation-of-the-Federal-Phthalates-Ban-Sold-Exclusively-on-Amazon Sling Carriers: https://www.cpsc.gov/Recalls/2024/Sling-Carriers-Recalled-Due-to-Infant-Suffocation-and-Fall-Hazards-Violation-of-the-Federal-Safety-Regulation-for-Sling-Carriers-Sold-on-Walmart-com-through-Joybuy-Marketplace-Express Children’s Pajama Sets: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online Children’s Nightgowns: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/25/2024 Number Present: 40 Completed Date: 7/25/2024 Age: From 0 To 5 Total Minutes: 235 Time In: 09:50 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit. A signed copy of the visit summary was left on-site for you. Today, the Administrator, Erin Betz, accompanied me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-seven (97) percentage as of 07/24/2024 The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Learning Tree LLC, is current/active as of 07/24/2024. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/3/23. The last fire drill was practiced on 6/10/24. The last lockdown drill was practiced on 5/23/24. The last playground inspection was documented on 6/11/24. The last fire inspection was approved on 10/5/23. The last sanitation inspection was conducted on 1/12/24 with three (3) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The EPR plan was updated 5/29/24. Upon arrival I introduced my presence to the Administrator, Erin Betz. I observed the group with three- to five-year-old children engaged in an art activity. The infants were being fed, interacting with the caregiver and having routine care. The one-year-old children were participating in routine care and eating. The two-year-olds were participating in free choice play and toilet training. The classroom for three-year-olds was temporarily closed. The outdoor learning environment offers adequate space for running and vigorous play with wheeled toys, balls and portable materials to enhance play. All interactions were positive, supervision was adequate. The staff and training worksheets were received prior to today's visit and were monitored for child care requirements. There is one (1) newly hired staff and seven (7) existing staff. The newly hired staff’s file and one (1) existing staff’s file was monitored during the visit. There are fifty-three (53) children enrolled. Five (5) child files were monitored during the visit. 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 program does not provide transportation. The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted in space #5. GS 110-91(12); .0508(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol sunscreen was in unlocked storage in space #3. .2820(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. ne (1) newly hired staff, K.W. did not have signed acknowledgement of the facility's shaken baby syndrome policy on file. .0608(d)(1-4) Technical assistance provided: 1874-The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. 428-A current activity plan was not posted for each group of children for reference. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. A current activity plan was not posted in space #5. A current activity plan was posted during the visit for correction. No further action is required. 840-All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. An aerosol sunscreen was in unlocked storage in space #3. The aerosol sunscreen was moved to locked storage during the visit for correction. No further action is required. Plan to review proper storage of materials with all staff. Consultation is provided as follows: We discussed the Emergency Preparedness Training section of the staff and training worksheet. We discussed a process to streamline staff files regarding signed acknowledgement of polices received. The U.S. Consumer Product Safety Commission has recalled a few items. I’ve provided you with a description of the recalled products and a link summarizing the recall and associated product. Please share with the families you serve. Power Adapters Sold with Rest 1st Generation Sound Machines: Power: https://www.cpsc.gov/Recalls/2024/Hatch-Baby-Recalls-Power-Adapters-Sold-with-Rest-1st-Generation-Sound-Machines-Due-to-Shock-Hazard Theefun Kids Gardening Tool Sets: https://www.cpsc.gov/Recalls/2024/Thousandshores-Recalled-Theefun-Kids-Gardening-Tools-Sets-Due-to-Violation-of-the-Federal-Phthalates-Ban-Sold-Exclusively-on-Amazon Sling Carriers: https://www.cpsc.gov/Recalls/2024/Sling-Carriers-Recalled-Due-to-Infant-Suffocation-and-Fall-Hazards-Violation-of-the-Federal-Safety-Regulation-for-Sling-Carriers-Sold-on-Walmart-com-through-Joybuy-Marketplace-Express Children’s Pajama Sets: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online Children’s Nightgowns: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/25/2024 Number Present: 40 Completed Date: 7/25/2024 Age: From 0 To 5 Total Minutes: 235 Time In: 09:50 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit. A signed copy of the visit summary was left on-site for you. Today, the Administrator, Erin Betz, accompanied me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-seven (97) percentage as of 07/24/2024 The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Learning Tree LLC, is current/active as of 07/24/2024. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/3/23. The last fire drill was practiced on 6/10/24. The last lockdown drill was practiced on 5/23/24. The last playground inspection was documented on 6/11/24. The last fire inspection was approved on 10/5/23. The last sanitation inspection was conducted on 1/12/24 with three (3) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The EPR plan was updated 5/29/24. Upon arrival I introduced my presence to the Administrator, Erin Betz. I observed the group with three- to five-year-old children engaged in an art activity. The infants were being fed, interacting with the caregiver and having routine care. The one-year-old children were participating in routine care and eating. The two-year-olds were participating in free choice play and toilet training. The classroom for three-year-olds was temporarily closed. The outdoor learning environment offers adequate space for running and vigorous play with wheeled toys, balls and portable materials to enhance play. All interactions were positive, supervision was adequate. The staff and training worksheets were received prior to today's visit and were monitored for child care requirements. There is one (1) newly hired staff and seven (7) existing staff. The newly hired staff’s file and one (1) existing staff’s file was monitored during the visit. There are fifty-three (53) children enrolled. Five (5) child files were monitored during the visit. 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 program does not provide transportation. The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted in space #5. GS 110-91(12); .0508(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol sunscreen was in unlocked storage in space #3. .2820(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. ne (1) newly hired staff, K.W. did not have signed acknowledgement of the facility's shaken baby syndrome policy on file. .0608(d)(1-4) Technical assistance provided: 1874-The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. 428-A current activity plan was not posted for each group of children for reference. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. A current activity plan was not posted in space #5. A current activity plan was posted during the visit for correction. No further action is required. 840-All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. An aerosol sunscreen was in unlocked storage in space #3. The aerosol sunscreen was moved to locked storage during the visit for correction. No further action is required. Plan to review proper storage of materials with all staff. Consultation is provided as follows: We discussed the Emergency Preparedness Training section of the staff and training worksheet. We discussed a process to streamline staff files regarding signed acknowledgement of polices received. The U.S. Consumer Product Safety Commission has recalled a few items. I’ve provided you with a description of the recalled products and a link summarizing the recall and associated product. Please share with the families you serve. Power Adapters Sold with Rest 1st Generation Sound Machines: Power: https://www.cpsc.gov/Recalls/2024/Hatch-Baby-Recalls-Power-Adapters-Sold-with-Rest-1st-Generation-Sound-Machines-Due-to-Shock-Hazard Theefun Kids Gardening Tool Sets: https://www.cpsc.gov/Recalls/2024/Thousandshores-Recalled-Theefun-Kids-Gardening-Tools-Sets-Due-to-Violation-of-the-Federal-Phthalates-Ban-Sold-Exclusively-on-Amazon Sling Carriers: https://www.cpsc.gov/Recalls/2024/Sling-Carriers-Recalled-Due-to-Infant-Suffocation-and-Fall-Hazards-Violation-of-the-Federal-Safety-Regulation-for-Sling-Carriers-Sold-on-Walmart-com-through-Joybuy-Marketplace-Express Children’s Pajama Sets: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online Children’s Nightgowns: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/25/2024 Number Present: 40 Completed Date: 7/25/2024 Age: From 0 To 5 Total Minutes: 235 Time In: 09:50 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit. A signed copy of the visit summary was left on-site for you. Today, the Administrator, Erin Betz, accompanied me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-seven (97) percentage as of 07/24/2024 The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Learning Tree LLC, is current/active as of 07/24/2024. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/3/23. The last fire drill was practiced on 6/10/24. The last lockdown drill was practiced on 5/23/24. The last playground inspection was documented on 6/11/24. The last fire inspection was approved on 10/5/23. The last sanitation inspection was conducted on 1/12/24 with three (3) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The EPR plan was updated 5/29/24. Upon arrival I introduced my presence to the Administrator, Erin Betz. I observed the group with three- to five-year-old children engaged in an art activity. The infants were being fed, interacting with the caregiver and having routine care. The one-year-old children were participating in routine care and eating. The two-year-olds were participating in free choice play and toilet training. The classroom for three-year-olds was temporarily closed. The outdoor learning environment offers adequate space for running and vigorous play with wheeled toys, balls and portable materials to enhance play. All interactions were positive, supervision was adequate. The staff and training worksheets were received prior to today's visit and were monitored for child care requirements. There is one (1) newly hired staff and seven (7) existing staff. The newly hired staff’s file and one (1) existing staff’s file was monitored during the visit. There are fifty-three (53) children enrolled. Five (5) child files were monitored during the visit. 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 program does not provide transportation. The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted in space #5. GS 110-91(12); .0508(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol sunscreen was in unlocked storage in space #3. .2820(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. ne (1) newly hired staff, K.W. did not have signed acknowledgement of the facility's shaken baby syndrome policy on file. .0608(d)(1-4) Technical assistance provided: 1874-The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. 428-A current activity plan was not posted for each group of children for reference. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. A current activity plan was not posted in space #5. A current activity plan was posted during the visit for correction. No further action is required. 840-All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. An aerosol sunscreen was in unlocked storage in space #3. The aerosol sunscreen was moved to locked storage during the visit for correction. No further action is required. Plan to review proper storage of materials with all staff. Consultation is provided as follows: We discussed the Emergency Preparedness Training section of the staff and training worksheet. We discussed a process to streamline staff files regarding signed acknowledgement of polices received. The U.S. Consumer Product Safety Commission has recalled a few items. I’ve provided you with a description of the recalled products and a link summarizing the recall and associated product. Please share with the families you serve. Power Adapters Sold with Rest 1st Generation Sound Machines: Power: https://www.cpsc.gov/Recalls/2024/Hatch-Baby-Recalls-Power-Adapters-Sold-with-Rest-1st-Generation-Sound-Machines-Due-to-Shock-Hazard Theefun Kids Gardening Tool Sets: https://www.cpsc.gov/Recalls/2024/Thousandshores-Recalled-Theefun-Kids-Gardening-Tools-Sets-Due-to-Violation-of-the-Federal-Phthalates-Ban-Sold-Exclusively-on-Amazon Sling Carriers: https://www.cpsc.gov/Recalls/2024/Sling-Carriers-Recalled-Due-to-Infant-Suffocation-and-Fall-Hazards-Violation-of-the-Federal-Safety-Regulation-for-Sling-Carriers-Sold-on-Walmart-com-through-Joybuy-Marketplace-Express Children’s Pajama Sets: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online Children’s Nightgowns: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/25/2024 Number Present: 40 Completed Date: 7/25/2024 Age: From 0 To 5 Total Minutes: 235 Time In: 09:50 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit. A signed copy of the visit summary was left on-site for you. Today, the Administrator, Erin Betz, accompanied me. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was ninety-seven (97) percentage as of 07/24/2024 The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Learning Tree LLC, is current/active as of 07/24/2024. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/3/23. The last fire drill was practiced on 6/10/24. The last lockdown drill was practiced on 5/23/24. The last playground inspection was documented on 6/11/24. The last fire inspection was approved on 10/5/23. The last sanitation inspection was conducted on 1/12/24 with three (3) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The EPR plan was updated 5/29/24. Upon arrival I introduced my presence to the Administrator, Erin Betz. I observed the group with three- to five-year-old children engaged in an art activity. The infants were being fed, interacting with the caregiver and having routine care. The one-year-old children were participating in routine care and eating. The two-year-olds were participating in free choice play and toilet training. The classroom for three-year-olds was temporarily closed. The outdoor learning environment offers adequate space for running and vigorous play with wheeled toys, balls and portable materials to enhance play. All interactions were positive, supervision was adequate. The staff and training worksheets were received prior to today's visit and were monitored for child care requirements. There is one (1) newly hired staff and seven (7) existing staff. The newly hired staff’s file and one (1) existing staff’s file was monitored during the visit. There are fifty-three (53) children enrolled. Five (5) child files were monitored during the visit. 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 program does not provide transportation. The following violations were documented during today’s visit Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted in space #5. GS 110-91(12); .0508(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. An aerosol sunscreen was in unlocked storage in space #3. .2820(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. ne (1) newly hired staff, K.W. did not have signed acknowledgement of the facility's shaken baby syndrome policy on file. .0608(d)(1-4) Technical assistance provided: 1874-The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual's name; (2) the date the center's policy was given and explained to the individual; (3) the individual's signature; and (4) the date the individual signed the acknowledgment. 428-A current activity plan was not posted for each group of children for reference. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. A current activity plan was not posted in space #5. A current activity plan was posted during the visit for correction. No further action is required. 840-All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. An aerosol sunscreen was in unlocked storage in space #3. The aerosol sunscreen was moved to locked storage during the visit for correction. No further action is required. Plan to review proper storage of materials with all staff. Consultation is provided as follows: We discussed the Emergency Preparedness Training section of the staff and training worksheet. We discussed a process to streamline staff files regarding signed acknowledgement of polices received. The U.S. Consumer Product Safety Commission has recalled a few items. I’ve provided you with a description of the recalled products and a link summarizing the recall and associated product. Please share with the families you serve. Power Adapters Sold with Rest 1st Generation Sound Machines: Power: https://www.cpsc.gov/Recalls/2024/Hatch-Baby-Recalls-Power-Adapters-Sold-with-Rest-1st-Generation-Sound-Machines-Due-to-Shock-Hazard Theefun Kids Gardening Tool Sets: https://www.cpsc.gov/Recalls/2024/Thousandshores-Recalled-Theefun-Kids-Gardening-Tools-Sets-Due-to-Violation-of-the-Federal-Phthalates-Ban-Sold-Exclusively-on-Amazon Sling Carriers: https://www.cpsc.gov/Recalls/2024/Sling-Carriers-Recalled-Due-to-Infant-Suffocation-and-Fall-Hazards-Violation-of-the-Federal-Safety-Regulation-for-Sling-Carriers-Sold-on-Walmart-com-through-Joybuy-Marketplace-Express Children’s Pajama Sets: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online Children’s Nightgowns: https://www.cpsc.gov/Recalls/2024/Childrens-Pajama-Sets-Recalled-Due-to-Burn-Hazard-and-Violation-of-Federal-Flammability-Standards-Sold-Exclusively-on-Temu-com-by-Fashion-Online 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 8/3/2023 Number Present: 50 Completed Date: 8/3/2023 Age: From 0 To 6 Total Minutes: 300 Time In: 09:00 AM Time Out: 02:00 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit An electronic signed copy of the visit summary was electronically emailed to you. Today, the Administrator, Erin Betz ,accompanied me during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 08/02/2023 The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 8/2/23. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/11/22. The last fire drill was practiced on 7/31/23. The last lockdown drill was practiced on 5/24/23. The last playground inspection was documented on 7/31/23. The last fire inspection was approved on 9/29/22. The last sanitation inspection was conducted on 3/8/23 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response Plan was updated 1/27/23. Upon arrival, I made my presence known to Erin Betz, Administrator. The children in space #1 were observed having story time with the teacher. The children in space #2 were observed participating in free choice play. The children in space #3 were observed having table activities with a teacher. The children in space #4 were observed having music and transitioning from free choice play. The children in space #5 were observed being held, being bottle fed, and moving about on the carpet area. The playgrounds have adequate space for running and vigorous play. The portable equipment offers opportunity for balancing, climbing, sand and water, dramatic play, riding toys and ball play. All interactions were positive and nurturing. Supervision was adequate. The staff and training worksheets were received via email prior to today's visit. The worksheets were monitored for child care requirements. Four (4) newly hired staff files and one (1) existing staff file were monitored for child care requirements. Six (6) child files were monitored for child care requirements. Medications on site, over the counter diaper creams and sunscreens, were monitored for child care requirements. 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. One staff, S.G. hired 6/19/23 had a medical statement on file dated 5/5/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a medical statement on file dated 2/19/21 which is older than 12 months prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff, S.G. hired 6/19/23 had a TB test on file dated 5/4/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a TB test on file dated 2/26/21 which is older than 12 months prior to employment. .0701(a) Technical assistance was provided as follows: #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. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: 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. Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. 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 8/17/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff member, S.G. must complete ITS-SIDS training by 8/19/23. We discussed that you have contacted the fire marshal for an inspection on or prior to 9/29/23. We discussed the revised Environmental Health Sanitation requirements. 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 8/3/2023 Number Present: 50 Completed Date: 8/3/2023 Age: From 0 To 6 Total Minutes: 300 Time In: 09:00 AM Time Out: 02:00 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit An electronic signed copy of the visit summary was electronically emailed to you. Today, the Administrator, Erin Betz ,accompanied me during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 08/02/2023 The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 8/2/23. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/11/22. The last fire drill was practiced on 7/31/23. The last lockdown drill was practiced on 5/24/23. The last playground inspection was documented on 7/31/23. The last fire inspection was approved on 9/29/22. The last sanitation inspection was conducted on 3/8/23 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response Plan was updated 1/27/23. Upon arrival, I made my presence known to Erin Betz, Administrator. The children in space #1 were observed having story time with the teacher. The children in space #2 were observed participating in free choice play. The children in space #3 were observed having table activities with a teacher. The children in space #4 were observed having music and transitioning from free choice play. The children in space #5 were observed being held, being bottle fed, and moving about on the carpet area. The playgrounds have adequate space for running and vigorous play. The portable equipment offers opportunity for balancing, climbing, sand and water, dramatic play, riding toys and ball play. All interactions were positive and nurturing. Supervision was adequate. The staff and training worksheets were received via email prior to today's visit. The worksheets were monitored for child care requirements. Four (4) newly hired staff files and one (1) existing staff file were monitored for child care requirements. Six (6) child files were monitored for child care requirements. Medications on site, over the counter diaper creams and sunscreens, were monitored for child care requirements. 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. One staff, S.G. hired 6/19/23 had a medical statement on file dated 5/5/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a medical statement on file dated 2/19/21 which is older than 12 months prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff, S.G. hired 6/19/23 had a TB test on file dated 5/4/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a TB test on file dated 2/26/21 which is older than 12 months prior to employment. .0701(a) Technical assistance was provided as follows: #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. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: 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. Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. 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 8/17/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff member, S.G. must complete ITS-SIDS training by 8/19/23. We discussed that you have contacted the fire marshal for an inspection on or prior to 9/29/23. We discussed the revised Environmental Health Sanitation requirements. 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 8/3/2023 Number Present: 50 Completed Date: 8/3/2023 Age: From 0 To 6 Total Minutes: 300 Time In: 09:00 AM Time Out: 02:00 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit An electronic signed copy of the visit summary was electronically emailed to you. Today, the Administrator, Erin Betz ,accompanied me during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 08/02/2023 The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 8/2/23. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/11/22. The last fire drill was practiced on 7/31/23. The last lockdown drill was practiced on 5/24/23. The last playground inspection was documented on 7/31/23. The last fire inspection was approved on 9/29/22. The last sanitation inspection was conducted on 3/8/23 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response Plan was updated 1/27/23. Upon arrival, I made my presence known to Erin Betz, Administrator. The children in space #1 were observed having story time with the teacher. The children in space #2 were observed participating in free choice play. The children in space #3 were observed having table activities with a teacher. The children in space #4 were observed having music and transitioning from free choice play. The children in space #5 were observed being held, being bottle fed, and moving about on the carpet area. The playgrounds have adequate space for running and vigorous play. The portable equipment offers opportunity for balancing, climbing, sand and water, dramatic play, riding toys and ball play. All interactions were positive and nurturing. Supervision was adequate. The staff and training worksheets were received via email prior to today's visit. The worksheets were monitored for child care requirements. Four (4) newly hired staff files and one (1) existing staff file were monitored for child care requirements. Six (6) child files were monitored for child care requirements. Medications on site, over the counter diaper creams and sunscreens, were monitored for child care requirements. 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. One staff, S.G. hired 6/19/23 had a medical statement on file dated 5/5/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a medical statement on file dated 2/19/21 which is older than 12 months prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff, S.G. hired 6/19/23 had a TB test on file dated 5/4/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a TB test on file dated 2/26/21 which is older than 12 months prior to employment. .0701(a) Technical assistance was provided as follows: #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. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: 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. Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. 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 8/17/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff member, S.G. must complete ITS-SIDS training by 8/19/23. We discussed that you have contacted the fire marshal for an inspection on or prior to 9/29/23. We discussed the revised Environmental Health Sanitation requirements. 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 8/3/2023 Number Present: 50 Completed Date: 8/3/2023 Age: From 0 To 6 Total Minutes: 300 Time In: 09:00 AM Time Out: 02:00 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit An electronic signed copy of the visit summary was electronically emailed to you. Today, the Administrator, Erin Betz ,accompanied me during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 08/02/2023 The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 8/2/23. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/11/22. The last fire drill was practiced on 7/31/23. The last lockdown drill was practiced on 5/24/23. The last playground inspection was documented on 7/31/23. The last fire inspection was approved on 9/29/22. The last sanitation inspection was conducted on 3/8/23 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response Plan was updated 1/27/23. Upon arrival, I made my presence known to Erin Betz, Administrator. The children in space #1 were observed having story time with the teacher. The children in space #2 were observed participating in free choice play. The children in space #3 were observed having table activities with a teacher. The children in space #4 were observed having music and transitioning from free choice play. The children in space #5 were observed being held, being bottle fed, and moving about on the carpet area. The playgrounds have adequate space for running and vigorous play. The portable equipment offers opportunity for balancing, climbing, sand and water, dramatic play, riding toys and ball play. All interactions were positive and nurturing. Supervision was adequate. The staff and training worksheets were received via email prior to today's visit. The worksheets were monitored for child care requirements. Four (4) newly hired staff files and one (1) existing staff file were monitored for child care requirements. Six (6) child files were monitored for child care requirements. Medications on site, over the counter diaper creams and sunscreens, were monitored for child care requirements. 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. One staff, S.G. hired 6/19/23 had a medical statement on file dated 5/5/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a medical statement on file dated 2/19/21 which is older than 12 months prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff, S.G. hired 6/19/23 had a TB test on file dated 5/4/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a TB test on file dated 2/26/21 which is older than 12 months prior to employment. .0701(a) Technical assistance was provided as follows: #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. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: 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. Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. 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 8/17/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff member, S.G. must complete ITS-SIDS training by 8/19/23. We discussed that you have contacted the fire marshal for an inspection on or prior to 9/29/23. We discussed the revised Environmental Health Sanitation requirements. 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 8/3/2023 Number Present: 50 Completed Date: 8/3/2023 Age: From 0 To 6 Total Minutes: 300 Time In: 09:00 AM Time Out: 02:00 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit An electronic signed copy of the visit summary was electronically emailed to you. Today, the Administrator, Erin Betz ,accompanied me during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 08/02/2023 The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 8/2/23. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/11/22. The last fire drill was practiced on 7/31/23. The last lockdown drill was practiced on 5/24/23. The last playground inspection was documented on 7/31/23. The last fire inspection was approved on 9/29/22. The last sanitation inspection was conducted on 3/8/23 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response Plan was updated 1/27/23. Upon arrival, I made my presence known to Erin Betz, Administrator. The children in space #1 were observed having story time with the teacher. The children in space #2 were observed participating in free choice play. The children in space #3 were observed having table activities with a teacher. The children in space #4 were observed having music and transitioning from free choice play. The children in space #5 were observed being held, being bottle fed, and moving about on the carpet area. The playgrounds have adequate space for running and vigorous play. The portable equipment offers opportunity for balancing, climbing, sand and water, dramatic play, riding toys and ball play. All interactions were positive and nurturing. Supervision was adequate. The staff and training worksheets were received via email prior to today's visit. The worksheets were monitored for child care requirements. Four (4) newly hired staff files and one (1) existing staff file were monitored for child care requirements. Six (6) child files were monitored for child care requirements. Medications on site, over the counter diaper creams and sunscreens, were monitored for child care requirements. 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. One staff, S.G. hired 6/19/23 had a medical statement on file dated 5/5/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a medical statement on file dated 2/19/21 which is older than 12 months prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff, S.G. hired 6/19/23 had a TB test on file dated 5/4/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a TB test on file dated 2/26/21 which is older than 12 months prior to employment. .0701(a) Technical assistance was provided as follows: #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. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: 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. Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. 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 8/17/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff member, S.G. must complete ITS-SIDS training by 8/19/23. We discussed that you have contacted the fire marshal for an inspection on or prior to 9/29/23. We discussed the revised Environmental Health Sanitation requirements. 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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: LEARNING TREE OF FLETCHER Facility ID: 45000388 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 8/3/2023 Number Present: 50 Completed Date: 8/3/2023 Age: From 0 To 6 Total Minutes: 300 Time In: 09:00 AM Time Out: 02:00 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Erin Betz, Administrator, during the visit An electronic signed copy of the visit summary was electronically emailed to you. Today, the Administrator, Erin Betz ,accompanied me during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89) percentage as of 08/02/2023 The North Carolina Secretary of State website was viewed prior to today’s visit and the company, Learning Tree, LCC is current/active as of 8/2/23. Permit type – One Star Child Care License issued 1/8/22. Special Services/Restrictions – Daytime care only; Children under 2 ½ years old in rooms with direct exits only. The last annual compliance visit was conducted on 8/11/22. The last fire drill was practiced on 7/31/23. The last lockdown drill was practiced on 5/24/23. The last playground inspection was documented on 7/31/23. The last fire inspection was approved on 9/29/22. The last sanitation inspection was conducted on 3/8/23 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response Plan was updated 1/27/23. Upon arrival, I made my presence known to Erin Betz, Administrator. The children in space #1 were observed having story time with the teacher. The children in space #2 were observed participating in free choice play. The children in space #3 were observed having table activities with a teacher. The children in space #4 were observed having music and transitioning from free choice play. The children in space #5 were observed being held, being bottle fed, and moving about on the carpet area. The playgrounds have adequate space for running and vigorous play. The portable equipment offers opportunity for balancing, climbing, sand and water, dramatic play, riding toys and ball play. All interactions were positive and nurturing. Supervision was adequate. The staff and training worksheets were received via email prior to today's visit. The worksheets were monitored for child care requirements. Four (4) newly hired staff files and one (1) existing staff file were monitored for child care requirements. Six (6) child files were monitored for child care requirements. Medications on site, over the counter diaper creams and sunscreens, were monitored for child care requirements. 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. One staff, S.G. hired 6/19/23 had a medical statement on file dated 5/5/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a medical statement on file dated 2/19/21 which is older than 12 months prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff, S.G. hired 6/19/23 had a TB test on file dated 5/4/22 which is older than 12 months prior to employment. One staff, C.B., hired 6/1/23 had a TB test on file dated 2/26/21 which is older than 12 months prior to employment. .0701(a) Technical assistance was provided as follows: #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. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: 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. Required for: All staff, including the director and individuals who volunteer more than once per week. Item Requirements: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. 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 8/17/23 Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Staff member, S.G. must complete ITS-SIDS training by 8/19/23. We discussed that you have contacted the fire marshal for an inspection on or prior to 9/29/23. We discussed the revised Environmental Health Sanitation requirements. 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. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, 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