Polenta Elementary School

G.S. 110-90 · Violation

Name of Operation: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: Visit Date: 9/30/2025 Number Present: 17 Completed Date: 9/30/2025 Age: From 4 To 5 Total Minutes: 105 Time In: 10:15 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance of applicable child care requirements during a routine unannounced visit. I monitored the indoor environments for compliance with child care requirements. Staff/child ratios, supervision, use of space and capacity were monitored for compliance. The permit, sanitation placard, evacuation plan, safe arrival and departure procedures, first aid chart, menus, daily schedules, staff/child ratios, emergency medical care plan, emergency telephone numbers and a summary of NC Child Care Law were all posted at the time of today's visit. The storage of medication and hazardous products was also monitored for compliance. Four new staff had been hired since the last visit. The new staff files were reviewed today, and the staff/training worksheet was completed. A fire drill was documented as completed on 9-15-25 at 2:32 pm with an evacuation of 30 seconds. An outdoor inspection was documented as completed on 9-19-25. A sanitation inspection was completed on 1-17-25 with 2 demerits and a superior classification. The children were observed playing in activity areas and participating in teacher directed group activities. A five star child care center license was issued to you on 8-10-22 with seven points in education, seven points in program and one quality point. Violation Number Comment Rule 1041 Prior to employment a Criminal Background Check was not completed. One employee did not complete a criminal background check prior to employment. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not available for two employees. G.S. 110-90.2(b) & (d) & .2703(e) Two violations of requirements pertaining to the criminal background check process were documented. One staff member, Sara A. Spitler, did not complete a criminal background check prior to working in the preschool classroom. Therefore, a current qualification letter was not available for review as required. I verified in ABCMS that Maria A. Jones had a provisional qualification letter which will expire on 10-15-25. However, a qualification letter was not available for review as required. Ms. Spitler cannot be present in the licensed preschool classroom until a current qualification letter is issued and available for review. Ms. Jones can only remain in the classroom until 10-15-25 unless she has a new qualification letter prior to the expiration of her current letter. I notified the Director of Preschool regarding these violations following the visit. Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website https://ncchildcare.ncdhhs.gov/on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 10-14-25. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: 0424-295L Visit Date: 5/7/2024 Number Present: 15 Completed Date: 5/7/2024 Age: From 4 To 5 Total Minutes: 30 Time In: 11:30 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to conduct a follow up to the 4-23-24 complaint visit. Leigh McKenzie-Lee, Child Care Consultant, accompanied me on today's visit. Staff/child ratio, capacity, use of space and permit restrictions were monitored. Limited monitoring of other child care requirements was completed. The children were observed in teacher directed activities and free play. Items that were documented during the 4-23-24 visit were monitored for compliance: Item # 113 - There were no additional suspected cases of child maltreatment to report since the complaint visit. An additional violation was not documented. Item # 303-The children were adequately supervising the children today. An additional violation was not documented. Item #832-The emergency medical care plan was posted and current. Item # 902 - The staff were observed responding to the children in a nurturing and appropriate manner. An additional violation was not documented. Item # 904 - No staff members were observed handling a child roughly. An additional violation was not documented. Item # 908 - No staff members were observed disciplining a child. An additional violation was not documented. Item # 1876 - No staff members were observed yelling at or shaming a child. An additional violation was not documented. Each of these items were marked as corrected based on today's visit. Therefore, a compliance letter for the 4-23-24 visit is no longer required. Violation Number Comment Rule 1041 Prior to employment a Criminal Background Check was not completed. A background check had not been completed for one staff member. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not on file for one staff member. G.S. 110-90.2(b) & (d) & .2703(e) A violation was documented today because a teacher was in the classroom who did not have a qualification letter on file. The same teacher, Laura Jenkins, was in the classroom during the annual compliance visit on April, 12, 2024 and I had a conversation with Patricia Robinson, Preschool Program Specialist, reminding her that the individual could not work in the classroom for the preschool children until she had a current qualification letter on file. I reminded you again today and I also informed you that to continue to allow the individual to work in the classroom without a qualification letter could be viewed as willful non compliance of child care rules and could result in an administrative action and possibly revocation of the child care license. All violations must be corrected immediately. Please send me a compliance letter (written statement) describing in detail how and when the above violations were corrected. The compliance letter must be received no later than 5-21-24. The compliance letter may be sent to me via email, if you do not have access to email, please ensure that your compliance letter is mailed in a timely manner and that you allow for delays with the mail service. If your compliance letter is mailed, a handwritten signature must be included. Contact me if you have questions regarding correction of the violations documented during today’s visit. If you are unable to correct all violations within the specified timeframe, send a compliance letter regarding violations that were corrected and a specific plan to correct the remaining violations. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. 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 .0802 · Violation

Name of Operation: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: 0424-295L Visit Date: 4/23/2024 Number Present: 16 Completed Date: 4/23/2024 Age: From 4 To 5 Total Minutes: 90 Time In: 11:30 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate allegations of non-compliance received by DCDEE on 4-19-24. In addition, a follow up to the annual compliance visit conducted on 4-12-24 was also conducted to ensure violations cited have been corrected. Child Care Consultant, Leigh McKenzie-Lee accompanied me on today’s visit. The allegations were as follows: There is a concern of inadequate supervision. There is a concern of inappropriate discipline. The allegation was reviewed with multiple staff members, including the staff present in space 124, staff members present in space 122, the principal and another employee at the school who works in space 124 as needed. The following was determined based on information provided and on observations made: The staff members shared today that all of the children in space 124 have special needs and it takes everyone working together to provide adequate supervision for the children, however, the former lead teacher in space 124 spent much of her time during the day on her phone or iPad or computer rather than helping to supervise the children. Several staff members interviewed today stated that the former lead teacher used inappropriate discipline techniques with the children. One example shared today occurred on February 7, 2024 when a child would not stay on his cot and the former lead teacher stated, “if you don’t lay down on your cot right now, I’m going to throw this book at you.” After making that comment to the child according to a staff member who was present in the classroom, the lead teacher then grabbed the child by the arm and basically pushed him down onto his cot. Another method of inappropriate discipline used by the former lead teacher was taking a child’s shoes and telling him he would not get them back until he acted right. According to the staff members, the child has special needs and would get extremely upset when his shoes were taken from him. The staff stated today that the former lead teacher had unrealistic expectations for the children such as being forced to sit a certain way during circle time. A staff member stated that the former lead teacher was very “gruff and rigid” with the children. A staff member who works in space 124 as needed stated that on one occasion when she was working in the classroom at naptime a child began having a seizure and when she called out for the assistant to call 911 the former lead teacher told the assistant not to call, but rather let the school nurse evaluate the child first. The staff member who was interviewed today stated that she told the assistant to continue with the call to 911 that it was a serious situation and the child needed to be checked out. The lead teacher was working on an online training when this occurred and after the incident stated "Well, now thanks to you I have to redo the entire training". According to the staff members and illustrated by this situation, it didn't seem that her priorities were on the children. The principal was notified about the former teacher’s treatment towards children and a copy of that email was obtained during the visit. The email confirmed all of the allegations described in the complaint report. Based on the information provided, the allegations regarding inadequate supervision and inappropriate discipline were confirmed and violations were documented. It was reported by the principal that the lead teacher in space 124 was placed on leave. The principal verified that the individual is no longer employed at the school. Violation Number Comment Rule 303 Children were not adequately supervised at all times. The lead teacher worked on her computer, iPad or phone rather help supervise the children. .1801(a)(1-5) 832 There was no written emergency medical care (EMC) plan. The emergency medical care plan was not followed. 10A NCAC 09 .0802(a) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A teacher was told not to call 911 when a child was having a seizure. G.S. 110-91(10) 904 Child was handled roughly. A child was pushed down on his cot. .1803(a)(1) 908 Discipline was not appropriate for the child's age and development. Children were expected to sit a certain way at circle time, and then punished if they got out of their chair. .1803(b) 1876 A child was yelled at, shamed, humiliated, frightened, threatened or bullied. A boy with special needs shoes were taken from him when he didn't "act right". .1803(a)(9) Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website (www.ncchildcare.nc.gov) on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. During the visit, we discussed the importance of adequate supervision and appropriate discipline based on the child's age and/or developmental level. As a certified developmental day site, you all serve children of varying needs and abilities. Adequate supervision is paramount and appropriate discipline techniques must be used with the children. I recommended that you reach out to the Partnership for Children of Johnston County regarding training on appropriate discipline for children with special needs. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 5-21-24. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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. 110-91 · Violation

Name of Operation: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: 0424-295L Visit Date: 4/23/2024 Number Present: 16 Completed Date: 4/23/2024 Age: From 4 To 5 Total Minutes: 90 Time In: 11:30 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate allegations of non-compliance received by DCDEE on 4-19-24. In addition, a follow up to the annual compliance visit conducted on 4-12-24 was also conducted to ensure violations cited have been corrected. Child Care Consultant, Leigh McKenzie-Lee accompanied me on today’s visit. The allegations were as follows: There is a concern of inadequate supervision. There is a concern of inappropriate discipline. The allegation was reviewed with multiple staff members, including the staff present in space 124, staff members present in space 122, the principal and another employee at the school who works in space 124 as needed. The following was determined based on information provided and on observations made: The staff members shared today that all of the children in space 124 have special needs and it takes everyone working together to provide adequate supervision for the children, however, the former lead teacher in space 124 spent much of her time during the day on her phone or iPad or computer rather than helping to supervise the children. Several staff members interviewed today stated that the former lead teacher used inappropriate discipline techniques with the children. One example shared today occurred on February 7, 2024 when a child would not stay on his cot and the former lead teacher stated, “if you don’t lay down on your cot right now, I’m going to throw this book at you.” After making that comment to the child according to a staff member who was present in the classroom, the lead teacher then grabbed the child by the arm and basically pushed him down onto his cot. Another method of inappropriate discipline used by the former lead teacher was taking a child’s shoes and telling him he would not get them back until he acted right. According to the staff members, the child has special needs and would get extremely upset when his shoes were taken from him. The staff stated today that the former lead teacher had unrealistic expectations for the children such as being forced to sit a certain way during circle time. A staff member stated that the former lead teacher was very “gruff and rigid” with the children. A staff member who works in space 124 as needed stated that on one occasion when she was working in the classroom at naptime a child began having a seizure and when she called out for the assistant to call 911 the former lead teacher told the assistant not to call, but rather let the school nurse evaluate the child first. The staff member who was interviewed today stated that she told the assistant to continue with the call to 911 that it was a serious situation and the child needed to be checked out. The lead teacher was working on an online training when this occurred and after the incident stated "Well, now thanks to you I have to redo the entire training". According to the staff members and illustrated by this situation, it didn't seem that her priorities were on the children. The principal was notified about the former teacher’s treatment towards children and a copy of that email was obtained during the visit. The email confirmed all of the allegations described in the complaint report. Based on the information provided, the allegations regarding inadequate supervision and inappropriate discipline were confirmed and violations were documented. It was reported by the principal that the lead teacher in space 124 was placed on leave. The principal verified that the individual is no longer employed at the school. Violation Number Comment Rule 303 Children were not adequately supervised at all times. The lead teacher worked on her computer, iPad or phone rather help supervise the children. .1801(a)(1-5) 832 There was no written emergency medical care (EMC) plan. The emergency medical care plan was not followed. 10A NCAC 09 .0802(a) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A teacher was told not to call 911 when a child was having a seizure. G.S. 110-91(10) 904 Child was handled roughly. A child was pushed down on his cot. .1803(a)(1) 908 Discipline was not appropriate for the child's age and development. Children were expected to sit a certain way at circle time, and then punished if they got out of their chair. .1803(b) 1876 A child was yelled at, shamed, humiliated, frightened, threatened or bullied. A boy with special needs shoes were taken from him when he didn't "act right". .1803(a)(9) Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website (www.ncchildcare.nc.gov) on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. During the visit, we discussed the importance of adequate supervision and appropriate discipline based on the child's age and/or developmental level. As a certified developmental day site, you all serve children of varying needs and abilities. Adequate supervision is paramount and appropriate discipline techniques must be used with the children. I recommended that you reach out to the Partnership for Children of Johnston County regarding training on appropriate discipline for children with special needs. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 5-21-24. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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 .0514 · Violation

Name of Operation: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 24 Completed Date: 4/12/2024 Age: From 4 To 5 Total Minutes: 110 Time In: 09:40 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance of applicable child care requirements during your annual compliance visit. I monitored the indoor and outdoor environments for compliance with applicable child care requirements. Staff/child ratios, supervision, use of space and capacity were monitored for compliance. The permit, sanitation, evacuation, safe arrival and departure procedures, first aid chart, menus, activity plan, daily schedule, staff/child ratios and a summary of NC Child Care Law were all posted at the time of the visit. The storage of medication and hazardous products was also monitored for compliance. Staff files were reviewed during the visit and the Staff and Training worksheet was completed. A sample of children's records were reviewed during the visit and the worksheet was completed. A fire drill was documented as conducted on 3-20-24 at 10:00 am. A lock down drill was documented as conducted on 2-8-24. An approved fire inspection was completed on 1-16-24. A sanitation inspection was last completed on 3-28-24 with zero demerits and a superior classification. The children were observed participating in free play activities, teacher directed activities and playing outside. I did not observe a meal or snack. A five star child care center license with seven points in education, seven points in program standards and one quality point was issued to you 5-13-22. Based on information provided and on observations made during the visit, you continue to meet the requirements previously met to obtain such a license. Violation Number Comment Rule 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Verification that the EMC plan was reviewed with two new employees was not available. 10A NCAC 09 .0802(a) 1030 Application for employment and date of birth was not on file for all staff. Verification that an application was on file for two new employees was not available. .0302(d)(1)(A) 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. Verification of a completed medical was not on file for two new employees. 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. Verification of a negative TB was not available for two new staff members. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Required emergency information was not on file for one new staff member. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. An employee was hired who had not completed a background check. G.S. 110-90.2(b) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Verification that orientation was completed was not available for two staff members. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Verification that personnel policies were discussed was not available for two staff members. 10A NCAC 09 .0514(e) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not available for review for two staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Verification that the EPR plan was reviewed was not available for two staff members. .0607(f) 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. Verification that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy was not available for one new staff member. .0608(d)(1-4) Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website (www.ncchildcare.nc.gov) on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 4-26-24. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 24 Completed Date: 4/12/2024 Age: From 4 To 5 Total Minutes: 110 Time In: 09:40 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance of applicable child care requirements during your annual compliance visit. I monitored the indoor and outdoor environments for compliance with applicable child care requirements. Staff/child ratios, supervision, use of space and capacity were monitored for compliance. The permit, sanitation, evacuation, safe arrival and departure procedures, first aid chart, menus, activity plan, daily schedule, staff/child ratios and a summary of NC Child Care Law were all posted at the time of the visit. The storage of medication and hazardous products was also monitored for compliance. Staff files were reviewed during the visit and the Staff and Training worksheet was completed. A sample of children's records were reviewed during the visit and the worksheet was completed. A fire drill was documented as conducted on 3-20-24 at 10:00 am. A lock down drill was documented as conducted on 2-8-24. An approved fire inspection was completed on 1-16-24. A sanitation inspection was last completed on 3-28-24 with zero demerits and a superior classification. The children were observed participating in free play activities, teacher directed activities and playing outside. I did not observe a meal or snack. A five star child care center license with seven points in education, seven points in program standards and one quality point was issued to you 5-13-22. Based on information provided and on observations made during the visit, you continue to meet the requirements previously met to obtain such a license. Violation Number Comment Rule 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Verification that the EMC plan was reviewed with two new employees was not available. 10A NCAC 09 .0802(a) 1030 Application for employment and date of birth was not on file for all staff. Verification that an application was on file for two new employees was not available. .0302(d)(1)(A) 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. Verification of a completed medical was not on file for two new employees. 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. Verification of a negative TB was not available for two new staff members. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Required emergency information was not on file for one new staff member. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. An employee was hired who had not completed a background check. G.S. 110-90.2(b) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Verification that orientation was completed was not available for two staff members. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Verification that personnel policies were discussed was not available for two staff members. 10A NCAC 09 .0514(e) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not available for review for two staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Verification that the EPR plan was reviewed was not available for two staff members. .0607(f) 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. Verification that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy was not available for one new staff member. .0608(d)(1-4) Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website (www.ncchildcare.nc.gov) on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 4-26-24. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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 .0802 · Violation

Name of Operation: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 24 Completed Date: 4/12/2024 Age: From 4 To 5 Total Minutes: 110 Time In: 09:40 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance of applicable child care requirements during your annual compliance visit. I monitored the indoor and outdoor environments for compliance with applicable child care requirements. Staff/child ratios, supervision, use of space and capacity were monitored for compliance. The permit, sanitation, evacuation, safe arrival and departure procedures, first aid chart, menus, activity plan, daily schedule, staff/child ratios and a summary of NC Child Care Law were all posted at the time of the visit. The storage of medication and hazardous products was also monitored for compliance. Staff files were reviewed during the visit and the Staff and Training worksheet was completed. A sample of children's records were reviewed during the visit and the worksheet was completed. A fire drill was documented as conducted on 3-20-24 at 10:00 am. A lock down drill was documented as conducted on 2-8-24. An approved fire inspection was completed on 1-16-24. A sanitation inspection was last completed on 3-28-24 with zero demerits and a superior classification. The children were observed participating in free play activities, teacher directed activities and playing outside. I did not observe a meal or snack. A five star child care center license with seven points in education, seven points in program standards and one quality point was issued to you 5-13-22. Based on information provided and on observations made during the visit, you continue to meet the requirements previously met to obtain such a license. Violation Number Comment Rule 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Verification that the EMC plan was reviewed with two new employees was not available. 10A NCAC 09 .0802(a) 1030 Application for employment and date of birth was not on file for all staff. Verification that an application was on file for two new employees was not available. .0302(d)(1)(A) 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. Verification of a completed medical was not on file for two new employees. 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. Verification of a negative TB was not available for two new staff members. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Required emergency information was not on file for one new staff member. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. An employee was hired who had not completed a background check. G.S. 110-90.2(b) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Verification that orientation was completed was not available for two staff members. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Verification that personnel policies were discussed was not available for two staff members. 10A NCAC 09 .0514(e) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not available for review for two staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Verification that the EPR plan was reviewed was not available for two staff members. .0607(f) 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. Verification that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy was not available for one new staff member. .0608(d)(1-4) Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website (www.ncchildcare.nc.gov) on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 4-26-24. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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: POLENTA ELEMENTARY SCHOOL Facility ID: 51000564 Consultant: PAULA DAVIS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 24 Completed Date: 4/12/2024 Age: From 4 To 5 Total Minutes: 110 Time In: 09:40 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance of applicable child care requirements during your annual compliance visit. I monitored the indoor and outdoor environments for compliance with applicable child care requirements. Staff/child ratios, supervision, use of space and capacity were monitored for compliance. The permit, sanitation, evacuation, safe arrival and departure procedures, first aid chart, menus, activity plan, daily schedule, staff/child ratios and a summary of NC Child Care Law were all posted at the time of the visit. The storage of medication and hazardous products was also monitored for compliance. Staff files were reviewed during the visit and the Staff and Training worksheet was completed. A sample of children's records were reviewed during the visit and the worksheet was completed. A fire drill was documented as conducted on 3-20-24 at 10:00 am. A lock down drill was documented as conducted on 2-8-24. An approved fire inspection was completed on 1-16-24. A sanitation inspection was last completed on 3-28-24 with zero demerits and a superior classification. The children were observed participating in free play activities, teacher directed activities and playing outside. I did not observe a meal or snack. A five star child care center license with seven points in education, seven points in program standards and one quality point was issued to you 5-13-22. Based on information provided and on observations made during the visit, you continue to meet the requirements previously met to obtain such a license. Violation Number Comment Rule 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Verification that the EMC plan was reviewed with two new employees was not available. 10A NCAC 09 .0802(a) 1030 Application for employment and date of birth was not on file for all staff. Verification that an application was on file for two new employees was not available. .0302(d)(1)(A) 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. Verification of a completed medical was not on file for two new employees. 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. Verification of a negative TB was not available for two new staff members. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. Required emergency information was not on file for one new staff member. .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. An employee was hired who had not completed a background check. G.S. 110-90.2(b) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Verification that orientation was completed was not available for two staff members. .1101(a) 1230 Personnel policies were not discussed with each staff at employment and a copy was not available to all staff. Verification that personnel policies were discussed was not available for two staff members. 10A NCAC 09 .0514(e) 1757 A valid qualification letter was not on file and available to review at the facility. A valid qualification letter was not available for review for two staff members. G.S. 110-90.2(b) & (d) & .2703(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Verification that the EPR plan was reviewed was not available for two staff members. .0607(f) 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. Verification that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma Policy was not available for one new staff member. .0608(d)(1-4) Child care licensing requirements are established to ensure a safe and healthy child care environment. Therefore, it is important for you to be knowledgeable of all the licensing requirements that apply to your program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times. The best way for you to make sure that you are meeting all requirements is to periodically review the childcare law and rules. I explained that you have access to the on-line version of the Child Care Rule Book, as well as a hard copy of the rules. I recommended that you visit the Division of Child Development's website (www.ncchildcare.nc.gov) on a regular basis to find out what's new in childcare. You could also find any needed Child Care forms by going on the web site and clicking on the "Provider" tab and then clicking on the "Provider Documents" tab. Please send me a written statement describing how and when the above violations were corrected. The written statement must be received no later than 4-26-24. Please note that if your letter is mailed, a hand written signature is required. As an alternative, compliance letters can now be submitted via email. I recommend emailing your letter to reduce the time needed to ensure my receipt of your information; however, if you do not have access to email, please ensure that your letter is mailed in a timely fashion and that you allow for any possible delays in the mail service. Please contact me if you have questions pertaining to your compliance letter or if you will not be able to meet the two-week timeframe for submission of your compliance letter. Please contact me at 919-819-9302 or at paula.davis@dhhs.nc.gov if I can be of assistance. Please use my local mailing address for submitting items directly to me: PO Box 696, Pine Level, NC 27568. 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