Appleville Academy

10A NCAC 09 .0806 · Violation

Name of Operation: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: WYTINA BLACKMON Operation Type: Center Case Number: Visit Date: 1/21/2026 Number Present: 62 Completed Date: 1/21/2026 Age: From 0 To 5 Total Minutes: 280 Time In: 10:05 AM Time Out: 02:45 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 checklist was used to note the requirements I monitored today. This facility currently operates with Four Star license issued on October 31 ,2021. Meg Riddle, Licensing supervisor accompanied me during today’s visit. Upon our arrival, we were greeted by A. Williams, assistant director. We informed her the purpose of today’s visit. Ms. Williams informed me that Ms. Douglass was out today. Ms. Williams gave us the necessary paperwork we needed to complete my visit. We observed and documented the attendance. All indoor and outdoor spaces used by the children were observed today. All required items were posted. All medication and hazardous items were out of the children's reach. Sixty-Two (62) children were present during today’s visit. We observed the children playing on the floor with available toys, playing in centers, washing their hands in preparation for lunch, eating lunch, napping, waking up from napping, washing their hands in preparation for snack, eating snack and departing. A sanitation inspection was conducted on October 7,2025. This facility received a superior rating with twelve (12) demerits. A fire inspection was conducted on January 13,2026. The original will be mailed to Raleigh with this documentation. I checked the NC Department of the Secretary of State for your corporation status. Your corporation status is active and current as of January 21,2026. Staff and children’s files were monitored during today’s visit. The staff and training worksheets were updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. Nine(9) violations were cited during today’s visit. Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. The sensory, books and fine motor materials were not provided to the children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. Two children's feeding plan was not updated as the children's feeding needs changed. 10 NCAC 09 .0902(a) 803 There were no clean clothes available for the children to wear when children's clothes became wet or soiled. Fifteen children did not have any available clothes to wear when their clothes became wet or soiled. 10A NCAC 09 .0806(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. There was one child's medication not returned to the parent after the expiration of the medication. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with thirteen staff annually. 10A NCAC 09 .0802(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three staff required to receive on-going training had not completed the required number of hours. .1103(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514(f) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The trained staff did not review the EPR Plan annually with thirteen staff. .0607(e) 1898 Staff did not complete the health and safety training within one year of employment. Three staff did not complete healthy and safety training within one year of employment. .1102(a) The above violations must be corrected immediately, and a letter must be emailed to me no later than February 4,2026 stating how each item was corrected. My email address is wytina.blackmon@dhhs.nc.gov. If I do not receive your letter by February 4,2026 /or if you do not address all violations, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the situation has not been corrected or addressed. Consultation: We discussed with Ms. Williams that the staff members need in-service training hours, It-SIDS, health and safety CPR and First Aid trainings by specific dates. Please refer to the staff/training worksheet. Rated License Assessment: We discussed with Ms. Williams the Rated license assessment process. Ms. Williams contacted Ms. Douglass on the telephone. Ms. Douglass stated that she was interested Pathway 1 and the facility has chosen to participate in the observation assessment. Ms. Douglass stated that she would make her final decision after the observation assessment has been completed. Clean Classrooms for Carolina Kids This facility completed the lead water on 1/30/2025. This test should be completed every three years. The facility has also completed lead paint has been submitted. The facility is waiting for the results. You can check your facility status: https://data.cleanwaterforuskids.org/data/north-carolina Thank you for your time. 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: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: WYTINA BLACKMON Operation Type: Center Case Number: Visit Date: 1/21/2026 Number Present: 62 Completed Date: 1/21/2026 Age: From 0 To 5 Total Minutes: 280 Time In: 10:05 AM Time Out: 02:45 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 checklist was used to note the requirements I monitored today. This facility currently operates with Four Star license issued on October 31 ,2021. Meg Riddle, Licensing supervisor accompanied me during today’s visit. Upon our arrival, we were greeted by A. Williams, assistant director. We informed her the purpose of today’s visit. Ms. Williams informed me that Ms. Douglass was out today. Ms. Williams gave us the necessary paperwork we needed to complete my visit. We observed and documented the attendance. All indoor and outdoor spaces used by the children were observed today. All required items were posted. All medication and hazardous items were out of the children's reach. Sixty-Two (62) children were present during today’s visit. We observed the children playing on the floor with available toys, playing in centers, washing their hands in preparation for lunch, eating lunch, napping, waking up from napping, washing their hands in preparation for snack, eating snack and departing. A sanitation inspection was conducted on October 7,2025. This facility received a superior rating with twelve (12) demerits. A fire inspection was conducted on January 13,2026. The original will be mailed to Raleigh with this documentation. I checked the NC Department of the Secretary of State for your corporation status. Your corporation status is active and current as of January 21,2026. Staff and children’s files were monitored during today’s visit. The staff and training worksheets were updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. Nine(9) violations were cited during today’s visit. Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. The sensory, books and fine motor materials were not provided to the children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. Two children's feeding plan was not updated as the children's feeding needs changed. 10 NCAC 09 .0902(a) 803 There were no clean clothes available for the children to wear when children's clothes became wet or soiled. Fifteen children did not have any available clothes to wear when their clothes became wet or soiled. 10A NCAC 09 .0806(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. There was one child's medication not returned to the parent after the expiration of the medication. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with thirteen staff annually. 10A NCAC 09 .0802(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three staff required to receive on-going training had not completed the required number of hours. .1103(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514(f) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The trained staff did not review the EPR Plan annually with thirteen staff. .0607(e) 1898 Staff did not complete the health and safety training within one year of employment. Three staff did not complete healthy and safety training within one year of employment. .1102(a) The above violations must be corrected immediately, and a letter must be emailed to me no later than February 4,2026 stating how each item was corrected. My email address is wytina.blackmon@dhhs.nc.gov. If I do not receive your letter by February 4,2026 /or if you do not address all violations, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the situation has not been corrected or addressed. Consultation: We discussed with Ms. Williams that the staff members need in-service training hours, It-SIDS, health and safety CPR and First Aid trainings by specific dates. Please refer to the staff/training worksheet. Rated License Assessment: We discussed with Ms. Williams the Rated license assessment process. Ms. Williams contacted Ms. Douglass on the telephone. Ms. Douglass stated that she was interested Pathway 1 and the facility has chosen to participate in the observation assessment. Ms. Douglass stated that she would make her final decision after the observation assessment has been completed. Clean Classrooms for Carolina Kids This facility completed the lead water on 1/30/2025. This test should be completed every three years. The facility has also completed lead paint has been submitted. The facility is waiting for the results. You can check your facility status: https://data.cleanwaterforuskids.org/data/north-carolina Thank you for your time. 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: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: WYTINA BLACKMON Operation Type: Center Case Number: Visit Date: 1/21/2026 Number Present: 62 Completed Date: 1/21/2026 Age: From 0 To 5 Total Minutes: 280 Time In: 10:05 AM Time Out: 02:45 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 checklist was used to note the requirements I monitored today. This facility currently operates with Four Star license issued on October 31 ,2021. Meg Riddle, Licensing supervisor accompanied me during today’s visit. Upon our arrival, we were greeted by A. Williams, assistant director. We informed her the purpose of today’s visit. Ms. Williams informed me that Ms. Douglass was out today. Ms. Williams gave us the necessary paperwork we needed to complete my visit. We observed and documented the attendance. All indoor and outdoor spaces used by the children were observed today. All required items were posted. All medication and hazardous items were out of the children's reach. Sixty-Two (62) children were present during today’s visit. We observed the children playing on the floor with available toys, playing in centers, washing their hands in preparation for lunch, eating lunch, napping, waking up from napping, washing their hands in preparation for snack, eating snack and departing. A sanitation inspection was conducted on October 7,2025. This facility received a superior rating with twelve (12) demerits. A fire inspection was conducted on January 13,2026. The original will be mailed to Raleigh with this documentation. I checked the NC Department of the Secretary of State for your corporation status. Your corporation status is active and current as of January 21,2026. Staff and children’s files were monitored during today’s visit. The staff and training worksheets were updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. Nine(9) violations were cited during today’s visit. Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. The sensory, books and fine motor materials were not provided to the children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. Two children's feeding plan was not updated as the children's feeding needs changed. 10 NCAC 09 .0902(a) 803 There were no clean clothes available for the children to wear when children's clothes became wet or soiled. Fifteen children did not have any available clothes to wear when their clothes became wet or soiled. 10A NCAC 09 .0806(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. There was one child's medication not returned to the parent after the expiration of the medication. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed with thirteen staff annually. 10A NCAC 09 .0802(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three staff required to receive on-going training had not completed the required number of hours. .1103(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514(f) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The trained staff did not review the EPR Plan annually with thirteen staff. .0607(e) 1898 Staff did not complete the health and safety training within one year of employment. Three staff did not complete healthy and safety training within one year of employment. .1102(a) The above violations must be corrected immediately, and a letter must be emailed to me no later than February 4,2026 stating how each item was corrected. My email address is wytina.blackmon@dhhs.nc.gov. If I do not receive your letter by February 4,2026 /or if you do not address all violations, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the situation has not been corrected or addressed. Consultation: We discussed with Ms. Williams that the staff members need in-service training hours, It-SIDS, health and safety CPR and First Aid trainings by specific dates. Please refer to the staff/training worksheet. Rated License Assessment: We discussed with Ms. Williams the Rated license assessment process. Ms. Williams contacted Ms. Douglass on the telephone. Ms. Douglass stated that she was interested Pathway 1 and the facility has chosen to participate in the observation assessment. Ms. Douglass stated that she would make her final decision after the observation assessment has been completed. Clean Classrooms for Carolina Kids This facility completed the lead water on 1/30/2025. This test should be completed every three years. The facility has also completed lead paint has been submitted. The facility is waiting for the results. You can check your facility status: https://data.cleanwaterforuskids.org/data/north-carolina Thank you for your time. 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 .0601 · Violation

Name of Operation: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: WYTINA BLACKMON Operation Type: Center Case Number: Visit Date: 3/3/2025 Number Present: 60 Completed Date: 3/3/2025 Age: From 0 To 5 Total Minutes: 440 Time In: 09:25 AM Time Out: 04:45 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 for compliance during an annual compliance visit. A checklist was used to note the requirements I monitored today. This facility currently operates with Four Star license issued on October 31 ,2021. Upon my arrival, I was greeted by A. Williams, assistant director. I informed her the purpose of today’s visit. Ms. Williams informed me that Ms. Douglass was on her way to the center. Ms. Williams gave me the necessary paperwork I needed to complete my visit. Ms. Douglass arrived shortly after my arrival and assisted me for the remainder of the visit. I observed and documented the attendance. All indoor and outdoor spaces used by the children were observed today. All required items were posted. All medication and hazardous items were out of the children's reach. Sixty (60) children were present during today’s visit. I observed the children playing on the floor with available toys, playing in centers, playing outside on the playground, washing their hands in preparation for lunch, eating lunch, napping waking up from napping, washing their hands in preparation for snack, eating snack and departing. A sanitation inspection was conducted on January 10,2025. This facility received a superior rating with nine (9) demerits. A fire inspection was conducted on January 13,2025. The original will be mailed to Raleigh with this documentation. We checked the NC Department of the Secretary of State on March 3,2025 for your corporation status. Your corporation status is active and current. Staff and children’s files were monitored during today’s visit. The staff and training worksheets were updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. Three (3) violations were cited during today’s visit. Violation Number Comment Rule 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. There was not a third activity in the book area in the three classrooms. .0510(d)(1) 807 A safe indoor and outdoor environment was not provided for the children. A safe outdoor environment was not provided for the children. There was a tree root in the fence causing a gap in the fence, the wooden border around the fence has split wood with sharp edges, and the base of the basketball goal has cement exposed with sharp edges. These are safety hazards. 10A NCAC 09 .0601(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. There was an EpiPen not returned to one parent after the medication had expired. .0803(12) The above violations must be corrected immediately, and a letter must be emailed no later than March 17,2025 stating how each item was corrected. My email address is wytina.blackmon@dhhs.nc.gov. If I do not receive your letter by March 17,2025 /or if you do not address all violations, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the situation has not been corrected or addressed. Consultation: I discussed with Ms. Douglass that the staff members need in-service training hours, It-SIDS, health and safety training, CPR and First Aid trainings by specific dates. Please refer to the staff/training worksheet. Technical Assistance: Today, I discussed in detail with Ms. Douglass the minimum qualification for staff. I will email you the section of the rule with this documentation. Medication: During today’s visit, there was prescribed medication that had expired. This medication had not been returned to the parent. You must return prescribed medication, topical creams and sunscreens back to the parents within 72 hours of the authorization date or when the topical creams are no longer being used for the children. There are several children’s topical creams, and permissions to admission form and medical action plans and expirations of medications are due by specific dates. Please have each teacher check their forms. Rated License Assessment: I discussed with Ms. Douglass the Rated license assessment process, the hold harmless has been extended until the new QRIS is implemented. This means that you are not required to go any further with a rated license assessment unless you want to proceed. Beginning on February 1, 2025, child care facilities will use the Environment Rating Scale – Third Edition for family child care homes, infant/toddler classrooms and preschool classrooms, if requesting a program assessment or reassessment. You can visit ncrlap.org for any upcoming training courses for the ITERS-3 and ECERS-3. WORKS: Today, there were a few staff that did not have their education evaluated. I explained to Ms. Douglass that in order to know how many training hours each member of staff is required, then their education will need to be evaluated to determine the required number recommend that Ms. Douglass submit the staff’s transcript with a letter giving information about the individual and the center's ID number. This way the transcript would not get lost or misplaced due to not having enough information to allow the transcripts to be evaluated. Please ensure that all new staff member’s education information is current in the W.O.R.K.S. database. Each staff member must register in the WORKS system as soon as they are hired at this location. We reviewed the instructions on the DCDEE website. Education evaluations can take some time to process so beginning the process early will help to ensure we have the accurate information needed to ensure your staff is meeting the minimum education requirements. Thank you for your time during today's visit. 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 .0803 · Violation

Name of Operation: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: WYTINA BLACKMON Operation Type: Center Case Number: Visit Date: 10/21/2024 Number Present: 59 Completed Date: 10/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 11:45 AM Time Out: 02:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced compliance visit. Ericka Bailey, a childcare consultant accompanied me during today’s visit. Upon our arrival, we were greeted by Ms. S. Douglass, the director. We introduced ourselves informed Ms. Douglass the purpose of today’s visit. Ms. Douglass gave me the necessary paperwork we needed to complete today’s visit. We observed and documented the attendance. Fifty-nine (59) children were present during today’s visit. They were observed being diapered and held, washing their hands in preparation for lunch, eating lunch and napping. Limited licensing requirements were monitored. The followings items were observed in compliance during today's visit: supervision, staff/child ratio: space capacity: proper storage of medications; use of approved space, permit posted; permit restrictions. Seven (7) violations were cited during today’s visit. Violation Number Comment Rule 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. A medication was administered without written authorization. These topical creams Vaseline, Destin have been used on the children without authorization to administer the topical ointments. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. Three children topical creams which included Vaseline with expiration dates 12/2020, Aquaphor 7/2024 and Hydrocortisone 3/2024 These creams have been used on the children after expiration date. 10A NCAC 09 .0803(1)(d) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Three new staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff did not successfully complete certification in First Aid appropriate to the age of children in care within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff did not successfully complete certification in CPR training appropriate to the age of the children in care within first 90 days of employment. .1102(d) 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. The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with one new staff prior to providing care with children. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Four staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) The above violations must be corrected immediately, and a letter must be sent to me no later than November 4 ,2024 stating how each item was corrected. My email address is wytina.blackmon@dhhs.nc.gov. If I do not receive your letter by November 4 ,2024 /or if you do not address all violations, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the situation has not been corrected or addressed. Consultation: We discussed with Ms. Douglass new staff members need in-service training hours, health, and safety training by specific dates. Please refer to the staff/training worksheet. During today’s visit, there were several medications that did not have authorization for the tropical creams as well as several of these creams were expired. These topical creams has been used on the children after expiration date and without authorization to administer the topical ointments. There are several children’s topical creams, and permissions to admission form and medical action plans and expirations of medications are due by specific dates. Please have each teacher to check their forms. Rated License Assessment: I also discussed with Ms. Douglass the Rated license assessment process the hold harmless has been extended until the new QRIS is implemented. This means that you are not required to go any further with a rated license assessment unless you want to proceed. Education: We discussed with Ms. Douglass to resubmit her education to apply to as an administrator and a lead teacher. This way you will know what you point level she qualifies for those positions. We also discussed NC Works for the other staff members. WORKS: Please ensure that all new staff member’s education information is current in the W.O.R.K.S. database. Each staff member must register in the WORKS system as soon as they are hired at this location. We reviewed the instructions on the DCDEE website. Education evaluations can take some time to process so beginning the process early will help to ensure we have the accurate information needed to ensure your staff is meeting minimum education requirements. Thank you for your time. 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 .0803 · Violation

Name of Operation: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: WYTINA BLACKMON Operation Type: Center Case Number: Visit Date: 10/21/2024 Number Present: 59 Completed Date: 10/21/2024 Age: From 0 To 5 Total Minutes: 155 Time In: 11:45 AM Time Out: 02:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during a routine unannounced compliance visit. Ericka Bailey, a childcare consultant accompanied me during today’s visit. Upon our arrival, we were greeted by Ms. S. Douglass, the director. We introduced ourselves informed Ms. Douglass the purpose of today’s visit. Ms. Douglass gave me the necessary paperwork we needed to complete today’s visit. We observed and documented the attendance. Fifty-nine (59) children were present during today’s visit. They were observed being diapered and held, washing their hands in preparation for lunch, eating lunch and napping. Limited licensing requirements were monitored. The followings items were observed in compliance during today's visit: supervision, staff/child ratio: space capacity: proper storage of medications; use of approved space, permit posted; permit restrictions. Seven (7) violations were cited during today’s visit. Violation Number Comment Rule 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. A medication was administered without written authorization. These topical creams Vaseline, Destin have been used on the children without authorization to administer the topical ointments. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. Three children topical creams which included Vaseline with expiration dates 12/2020, Aquaphor 7/2024 and Hydrocortisone 3/2024 These creams have been used on the children after expiration date. 10A NCAC 09 .0803(1)(d) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Three new staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff did not successfully complete certification in First Aid appropriate to the age of children in care within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff did not successfully complete certification in CPR training appropriate to the age of the children in care within first 90 days of employment. .1102(d) 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. The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with one new staff prior to providing care with children. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Four staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) The above violations must be corrected immediately, and a letter must be sent to me no later than November 4 ,2024 stating how each item was corrected. My email address is wytina.blackmon@dhhs.nc.gov. If I do not receive your letter by November 4 ,2024 /or if you do not address all violations, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the situation has not been corrected or addressed. Consultation: We discussed with Ms. Douglass new staff members need in-service training hours, health, and safety training by specific dates. Please refer to the staff/training worksheet. During today’s visit, there were several medications that did not have authorization for the tropical creams as well as several of these creams were expired. These topical creams has been used on the children after expiration date and without authorization to administer the topical ointments. There are several children’s topical creams, and permissions to admission form and medical action plans and expirations of medications are due by specific dates. Please have each teacher to check their forms. Rated License Assessment: I also discussed with Ms. Douglass the Rated license assessment process the hold harmless has been extended until the new QRIS is implemented. This means that you are not required to go any further with a rated license assessment unless you want to proceed. Education: We discussed with Ms. Douglass to resubmit her education to apply to as an administrator and a lead teacher. This way you will know what you point level she qualifies for those positions. We also discussed NC Works for the other staff members. WORKS: Please ensure that all new staff member’s education information is current in the W.O.R.K.S. database. Each staff member must register in the WORKS system as soon as they are hired at this location. We reviewed the instructions on the DCDEE website. Education evaluations can take some time to process so beginning the process early will help to ensure we have the accurate information needed to ensure your staff is meeting minimum education requirements. Thank you for your time. 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 .1801 · Violation

Name of Operation: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: CAROLINE SYKES Operation Type: Center Case Number: 0824-421L Visit Date: 9/3/2024 Number Present: 51 Completed Date: 9/3/2024 Age: From 0 To 4 Total Minutes: 90 Time In: 10:30 AM Time Out: 12:00 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 monitor compliance with applicable child care requirements pertinent to a complaint visit. Limited monitoring was conducted today. We informed the administrator, Ms. Douglas, of the purpose of our visit. Kaye Adkins, licensing supervisor, accompanied me today. The allegation is as follows: There are concerns regarding supervision and records. Findings: We spoke with 2 staff members and 1 administrator. One staff member reported to us that she was lining her children up and bringing them inside from the playground. As they made their way inside, the last child in the line closed the door, remaining outside. He immediately ran around the building to the 2-year-old playground where he encountered another class. The teacher in that class took him back to his classroom. The other staff member told me she saw a child enter the playground through the gate from the adjoining playground. She asked the child where his class was and he said they were inside. She took the child back to his classroom. The administrator told us that a child had left his teacher as they were coming inside from the playground and ran to the adjoining playground. She stated that there was another class on the playground and that the teacher returned him back to his class. Based on our observations and the information gathered: 1. We find the allegation regarding the violation of supervision substantiated. 2. We find the allegation regarding the violation of records unsubstantiated. We observed children engaging in circle time, indoor and outdoor play. The following violations were cited. Violation Number Comment Rule 303 Children were not adequately supervised at all times. A child was unattended on the playground when he ran from his class as they were coming inside. He ran to another playground where a class was outside. .1801(a)(1-5) The above violations must be corrected immediately. I must receive a compliance statement/ letter by email or mail by 9/17/2024. In the letter, include the following information: 1. Your facility ID# and Name 2. Visit date 3. Violation item number(s) 4. How and when the violation was corrected (Be specific) 5. Your signature/name and position My email address is caroline.sykes@dhhs.nc.gov, and the mailing address is 3860 Dodson Lane, Haw River, NC 27258. Technical Assistance 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. At the completion of the visit, I reviewed the visit with Ms. Douglas and provided an opportunity to ask questions regarding the interpretation and implementation of child care requirements. If you have any questions or concerns, you may reach me at 336-266-4938 or email me at caroline.sykes@dhhs.nc.gov. You may also contact my supervisor Kaye Adkins at kaye.adkins@dhhs.nc.gov. Thank you for your assistance during today's visit 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 .2818 · Violation

Name of Operation: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: MIRANDA GARTNER Operation Type: Center Case Number: 0824-177A Visit Date: 8/16/2024 Number Present: 44 Completed Date: 8/16/2024 Age: From 1 To 5 Total Minutes: 165 Time In: 10:15 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 this unannounced visit was to investigate allegations of violations of child care requirements at this child care facility. Abigail Rowe, Investigations Consultant, was also present during the visit. Shamara McCormick, Administrator of High Point Facility, accompanied us during a walk-through of the facility. During the visit, we discussed the allegations with Stephanie Douglas, Administrator, Ms. McCormick, and three additional staff members. Limited monitoring of child care requirements occurred during today's visit. The following violations were confirmed during today's visit. Violation Number Comment Rule 853 Incident logs were not completed and maintained as required. It was verified during today's visit on 08/16/2024, an incident log was not maintained as required. .0802(g)(1-6) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. On 08/09/2024, a staff member was holding items in their right hand and used their left hand to lift a one-year-old child by their right bicep and placed them on their hip. G.S. 110-91(10) 1756 Enhanced staff/child ratios and group sizes were not met. On 08/09/2024, a staff member stayed behind to change the diaper of a child while another staff member went out to the playground. This placed one staff member with eight one-year-old children. The class was out of ratio for approximately a minute and a half. 10A NCAC 09 .2818 Violations must be corrected immediately. Within one week, 08/23/2024, you must submit documentation of the corrections you made and your plan to maintain compliance with the identified child care requirements to me at Miranda Gartner, Lead Investigations Consultant, miranda.gartner@dhhs.nc.gov, 336-247-5428. You may contact me at Miranda Gartner, Lead Investigations Consultant, miranda.gartner@dhhs.nc.gov, 336-247-5428 or Veronica Grant, South Central Investigations Team Supervisor, veronica.grant@dhhs.nc.gov. Thank you for your time. 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: APPLEVILLE ACADEMY Facility ID: 41002391 Consultant: MIRANDA GARTNER Operation Type: Center Case Number: 0824-177A Visit Date: 8/16/2024 Number Present: 44 Completed Date: 8/16/2024 Age: From 1 To 5 Total Minutes: 165 Time In: 10:15 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 this unannounced visit was to investigate allegations of violations of child care requirements at this child care facility. Abigail Rowe, Investigations Consultant, was also present during the visit. Shamara McCormick, Administrator of High Point Facility, accompanied us during a walk-through of the facility. During the visit, we discussed the allegations with Stephanie Douglas, Administrator, Ms. McCormick, and three additional staff members. Limited monitoring of child care requirements occurred during today's visit. The following violations were confirmed during today's visit. Violation Number Comment Rule 853 Incident logs were not completed and maintained as required. It was verified during today's visit on 08/16/2024, an incident log was not maintained as required. .0802(g)(1-6) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. On 08/09/2024, a staff member was holding items in their right hand and used their left hand to lift a one-year-old child by their right bicep and placed them on their hip. G.S. 110-91(10) 1756 Enhanced staff/child ratios and group sizes were not met. On 08/09/2024, a staff member stayed behind to change the diaper of a child while another staff member went out to the playground. This placed one staff member with eight one-year-old children. The class was out of ratio for approximately a minute and a half. 10A NCAC 09 .2818 Violations must be corrected immediately. Within one week, 08/23/2024, you must submit documentation of the corrections you made and your plan to maintain compliance with the identified child care requirements to me at Miranda Gartner, Lead Investigations Consultant, miranda.gartner@dhhs.nc.gov, 336-247-5428. You may contact me at Miranda Gartner, Lead Investigations Consultant, miranda.gartner@dhhs.nc.gov, 336-247-5428 or Veronica Grant, South Central Investigations Team Supervisor, veronica.grant@dhhs.nc.gov. Thank you for your time. 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