10A NCAC 09 .0803 · Violation

Name of Operation: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: SHEREEN PICKETT Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 86 Completed Date: 12/3/2024 Age: From 2 To 5 Total Minutes: 150 Time In: 09:00 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 annual compliance visit was to monitor compliance with applicable child care requirements. This facility currently operates with a Four-Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in the building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted by Child Care Consultant Tammy Ross on December 13, 2023. Prior to this visit, the facility’s 18-month compliance history of 94%. Fire Inspection – November 12, 2024 - PASS Sanitation Inspection – May 30, 2024 – Superior Classification Owner/Administrator, Steph Nestor, arrived approximately 30 minutes into the visit. Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. I conducted the walkthrough of building A unaccompanied. Ms. Nester accompanied me on the walkthrough of building B. There were one hundred children enrolled and eighty-six children, ages 2-5, present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. Children in spaces 1, 4 and 6 were engaged in free play, accessing a variety of age-appropriate materials. Children in spaces 2 and 5 were engaged in outdoor play. Children in space 3 were seated for morning group time. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. The following violations were observed and must be corrected immediately. Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. In Space 1, an epi-pen used with a child expired in November 2024. 10A NCAC 09 .0803(1)(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In space 1, zyrtec, used with a child as part of a medical action plan was not in its original container. 10A NCAC 09 .0803(4) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 13, 2024. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Technical Assistance Related to Violations Cited: Today there was an epi-pen that was expired in Space 1. Expired medications must be returned to the parents and new medication received must be accompanied by a new permission to administer form as this form will contain the medication expiration date. Also, all medications must be stored in their original container/box, such as the Zyrtec needed for the allergy plan in space 1. I encourage you to put a system in place to ensure medication expiration dates are checked often. In addition, ensure all medications parents brought into your program are in their original container. Reminders: The activity plan in space 3 was not current. However, a current plan was available and posted during the visit. I encourage you to post weekly activity plans each Friday prior to departing so they are ready to be used Monday morning. At the conclusion of this visit, the summary was reviewed with you, signed and a copy was left with you. Reach me at (910) 508-3228 or Shereen.pickett@dhhs.nc.gov with questions or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

NC GS 110-90 · Violation

Name of Operation: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: SHEREEN PICKETT Operation Type: Center Case Number: Visit Date: 12/3/2024 Number Present: 86 Completed Date: 12/3/2024 Age: From 2 To 5 Total Minutes: 150 Time In: 09:00 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 annual compliance visit was to monitor compliance with applicable child care requirements. This facility currently operates with a Four-Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in the building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted by Child Care Consultant Tammy Ross on December 13, 2023. Prior to this visit, the facility’s 18-month compliance history of 94%. Fire Inspection – November 12, 2024 - PASS Sanitation Inspection – May 30, 2024 – Superior Classification Owner/Administrator, Steph Nestor, arrived approximately 30 minutes into the visit. Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. I conducted the walkthrough of building A unaccompanied. Ms. Nester accompanied me on the walkthrough of building B. There were one hundred children enrolled and eighty-six children, ages 2-5, present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. Children in spaces 1, 4 and 6 were engaged in free play, accessing a variety of age-appropriate materials. Children in spaces 2 and 5 were engaged in outdoor play. Children in space 3 were seated for morning group time. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. The following violations were observed and must be corrected immediately. Violation Number Comment Rule 843 A drug or medicine was administered after its expiration date. In Space 1, an epi-pen used with a child expired in November 2024. 10A NCAC 09 .0803(1)(d) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In space 1, zyrtec, used with a child as part of a medical action plan was not in its original container. 10A NCAC 09 .0803(4) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before December 13, 2024. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Technical Assistance Related to Violations Cited: Today there was an epi-pen that was expired in Space 1. Expired medications must be returned to the parents and new medication received must be accompanied by a new permission to administer form as this form will contain the medication expiration date. Also, all medications must be stored in their original container/box, such as the Zyrtec needed for the allergy plan in space 1. I encourage you to put a system in place to ensure medication expiration dates are checked often. In addition, ensure all medications parents brought into your program are in their original container. Reminders: The activity plan in space 3 was not current. However, a current plan was available and posted during the visit. I encourage you to post weekly activity plans each Friday prior to departing so they are ready to be used Monday morning. At the conclusion of this visit, the summary was reviewed with you, signed and a copy was left with you. Reach me at (910) 508-3228 or Shereen.pickett@dhhs.nc.gov with questions or concerns. 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: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: SHEREEN PICKETT Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 58 Completed Date: 7/1/2024 Age: From 2 To 5 Total Minutes: 120 Time In: 10:20 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s routine unannounced visit was to monitor compliance with applicable child care requirements. This facility currently operates with a Four-Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in the building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted on December 13, 2023. Prior to this visit, the facility’s 18-month compliance history of 94%. Fire Inspection – December 11, 2023 - PASS Sanitation Inspection – May 30, 2024 – Superior Classification Owner/Administrator, Steph Nestor, was not present arrived approximately 30 minutes into the visit. Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. Ms. Thacker accompanied me as I completed a walkthrough of the facility. There were eighty-six children enrolled and fifty-eight children, ages 2-5, were present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. The two-year-old and three-year-old children in Space 6 were outside, enjoying a variety of gross motor play. Children in spaces 1, 2, 4, and 5 were observed in indoor spaces engaged in activity areas with scissors, dress-up clothes, stringing beads, making snowflake ornaments, painting, and pom-pom and rice sensory bins. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. One violation was observed and must be corrected immediately. 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. In space 1, an epi-pen was present to use with a child without a completed action plan or permission to administer form. 10A NCAC 09 .0803(1)(a & b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before July 10, 2024. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Technical Assistance Related to Violation Cited: For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application and stored with the medication. The medical action plan shall be completed by the child's parent and health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. This plan is only needed for those children with the previously listed conditions. All medications must be accompanied by written authorizations from parents with complete instructions for administration. Prescription medications must also be in the original container with the pharmacy label attached. Today I suggested that you review medication requirements with staff and periodically check behind them to ensure all requirements are met. Reminders: Mulch on all playgrounds need to be fluffed to ensure proper surfacing under and around fall zones. Due to the increase in rain, we have seen in the past week, the grass is growing rapidly. Ensure your maintenance crew are cutting the grass and treating weeds more often during this season. The rug in space 4 needs to be taped down so that is it not a tripping hazard. At the conclusion of this visit, the summary was reviewed with you, signed and a copy was left with you. Reach me at (910) 508-3228 or Shereen.pickett@dhhs.nc.gov with questions or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

NC GS 110-90 · Violation

Name of Operation: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: SHEREEN PICKETT Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 58 Completed Date: 7/1/2024 Age: From 2 To 5 Total Minutes: 120 Time In: 10:20 AM Time Out: 12:20 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s routine unannounced visit was to monitor compliance with applicable child care requirements. This facility currently operates with a Four-Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in the building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted on December 13, 2023. Prior to this visit, the facility’s 18-month compliance history of 94%. Fire Inspection – December 11, 2023 - PASS Sanitation Inspection – May 30, 2024 – Superior Classification Owner/Administrator, Steph Nestor, was not present arrived approximately 30 minutes into the visit. Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. Ms. Thacker accompanied me as I completed a walkthrough of the facility. There were eighty-six children enrolled and fifty-eight children, ages 2-5, were present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. The two-year-old and three-year-old children in Space 6 were outside, enjoying a variety of gross motor play. Children in spaces 1, 2, 4, and 5 were observed in indoor spaces engaged in activity areas with scissors, dress-up clothes, stringing beads, making snowflake ornaments, painting, and pom-pom and rice sensory bins. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. One violation was observed and must be corrected immediately. 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. In space 1, an epi-pen was present to use with a child without a completed action plan or permission to administer form. 10A NCAC 09 .0803(1)(a & b) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before July 10, 2024. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Technical Assistance Related to Violation Cited: For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application and stored with the medication. The medical action plan shall be completed by the child's parent and health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. This plan is only needed for those children with the previously listed conditions. All medications must be accompanied by written authorizations from parents with complete instructions for administration. Prescription medications must also be in the original container with the pharmacy label attached. Today I suggested that you review medication requirements with staff and periodically check behind them to ensure all requirements are met. Reminders: Mulch on all playgrounds need to be fluffed to ensure proper surfacing under and around fall zones. Due to the increase in rain, we have seen in the past week, the grass is growing rapidly. Ensure your maintenance crew are cutting the grass and treating weeds more often during this season. The rug in space 4 needs to be taped down so that is it not a tripping hazard. At the conclusion of this visit, the summary was reviewed with you, signed and a copy was left with you. Reach me at (910) 508-3228 or Shereen.pickett@dhhs.nc.gov with questions or concerns. 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: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: TAMMY ROSS Operation Type: Center Case Number: Visit Date: 7/20/2023 Number Present: 51 Completed Date: 7/20/2023 Age: From 2 To 12 Total Minutes: 120 Time In: 10:00 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 routine unannounced visit was to monitor compliance with applicable child care requirements. Limited child care requirements pertinent to this visit type were monitored. Child Care Consultant, April Bosse, assisted with this visit. This facility currently operates with a Four Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted on December 21, 2022. This facility has an 18-month compliance history of 98%. Fire Inspection – November 21, 2022 - PASS Sanitation Inspection – May 23, 2023 – 8 Demerits – Superior Owner/Administrator, Steph Nestor, arrived as we were finishing up the visit. However, Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. Ms. Thacker accompanied Ms. Bosse as she completed a walkthrough of the facility. There are sixty-six children enrolled and fifty-one children, ages 2-11, were present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. The two-year-old and three-year-old children in space 6 and preschool children in Space 5 were engaged in group time reading various books the children chose, finishing morning snack provided by parents or engaged in activity areas with lacing and tying boards, blocks, geo rock collections and puzzles. Children in spaces 1 and 2 were observed in indoor spaces engaged in activity areas with blocks, dress-up clothing, coloring with colored pencils and small manipulative toys. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. During today's visit child care requirements monitored for compliance included supervision, staff/child ratio, CPR and First Aid, Criminal Record Checks, storage of hazardous substances and medications, approved space, licensing requirements, new staff and program records, posting of the license, and other applicable requirements. There were three violations documented today. All violation must be corrected immediately. Continued compliance with applicable child care requirements is required. Violation Number Comment Rule 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member hired July 17, 2023 had a TB screening on file that was older than 12 months. .0701(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. Two staff members whose First Aid expired in July 2023 and April 2023 did not successfully complete certification in First Aid before expiration of current certifications as it was not in the staff file. .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. Two staff members whose CPR expired in July 2023 and April 2023 did not complete certification in CPR training prior to expiration and was not available in staff files. .1102(d) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. This information was not available for four staff members during today's visit. .1103(b) In order for your facility to remain in compliance with NC Child Care Requirements, violations must be corrected immediately. A signed and dated letter of compliance must be received July 27, 2023 describing how each violation was corrected and how compliance will be maintained in the future. The time frame is established to allow you time for submitting your compliance letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. If I can be of further assistance, please do not hesitate to contact me at (910)824-1143 or you can email me at Tammy.Ross@dhhs.nc.gov. You may email me your verification or mail it to me at: Tammy Ross, Child Care Licensing Consultant, P.O. Box 278, Jacksonville, NC 28541 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. 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 of the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times whether or not they have been monitored or specifically discussed with you in the past. The best way for you to make sure that you are meeting all requirements is to periodically review the child care law and rules. Comments regarding violations cited today Health & Safety Training- These training topics outlined in Child Care Rule 10A NCAC 09 .1703(b) must be completed within the first year of employment for new staff, with the exception of Recognizing and Responding to Suspicions of Child Maltreatment – it must be completed within 90 days of hire. After initial completion of Health and Safety Trainings, they must be completed every five years. Use the Health and Safety Training Record which is found on the DCDEE website under Provider Documents and Forms to track the completion of these trainings. During today’s visit, four staff members did not have verification on file for renewing/completing Recognizing and Responding to Suspicions of Child Maltreatment. Completing, refreshing, and updating the required Health and Safety Training increases your awareness and knowledge regarding child development and safety. CPR/FA - All staff must have current CPR/FA at all times. These training for two staff members have expired. It expired for S. Nestor on July 4, 2023 and for B. Collins on April 16, 2023. CPR/FA training must be renewed immediately. TB skin test must be completed and on file from day one of employment. TB skin results must indicate staff member is free of active TB and/or TB test or screening must be less than 12 months. Technical Assistance: Permission to Administer Medication Form: Child Care Rule 10A NCAC 09 .0803 (8) ADMINISTERING MEDICATION IN CHILD CARE CENTERS states a parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. This form should accompany the action plan for a child where medication is required to be given. This form can be found on the DCDEE website under the provider documents. Locking Storage: Today we discussed reviewing sanitation rule 15A NCAC 18A .2820 STORAGE regarding storage and accessibility of potentially hazardous items with all staff as there are many cabinets that have child locks on them and not a lock that must be unlocked with a key or combination. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor and do not have to be locked. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as non-emergency medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Reviewing these rules with staff will ensure that products continue to be stored correctly. Storage of Emergency Medications: Today technical assistance was given regarding how to safely store emergency medication so that it is available if needed quickly. Child Care Rule 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT states designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol. Other Information: On March 13, 2023, the Military Child Care in Your Neighborhood-PLUS (MCCYN-PLUS) initiative launched in North Carolina to make it easier for military families to access and afford quality child care from community providers. Licensed child care facilities are now able to participate in MCCYN-PLUS based on their star rating. If you are interested in participating in the military fee assistance program, please visit https://www.childcareaware.org/fee-assistancerespite/feeassistancerespiteproviders/feeassistance/ to review the application process. Rated License Reassessment Information Your facility’s three-year rated license reassessment was due to be completed August 2023, but was not completed due to reassessments being voluntary during the COVID-19 pandemic. As discussed today, reassessments will not become mandatory again until July 1, 2024, and your facility has been placed into “Cohort 2.” Placement in this cohort means you will have from July 1, 2024 to June 30, 2025 to plan and prepare for your reassessment, with your reassessment being due between July 1, 2025 and June 30, 2026. In your planning year, you may review resources available at www.ncrlap.org and contact Smart Start of Pender County or Region 4 CCR&R for assistance with completion of the self-study component. I am also available to assist you upon request. This is an opportunity to focus on your Star Rated License and consider strategies to help maintain or increase your star rating. Use staff meetings to discuss topics related to the Environment Rating Scales or other quality initiatives. For example, if transitions are challenging, ask staff what strategies help, or which transitions including a contact hour earning webinar and Thinking More worksheets for every rating scale. Engage to brainstorm, offer support and clarification, and set goals. Allocate resources so they can focus on self-study as part of the workday to help everyone become more familiar and confident with the assessment process. Also, be reminded that you may voluntarily request a reassessment at any time by contacting me, and that NCRLAP outreach assessments may still being offered if you wish to “practice.” You may also wish to contact technical assistance specialists with One Place to help you with mock assessments. Related to education, ensure you are uploading education has staff completed classwork. For any questions about the NC Early Childhood Equivalency exam, please contact: DCDEE.Equivalency.Exam@dhhs.nc.gov. This information can also be found on the DCDEE website (https://ncchildcare.ncdhhs.gov/) under the What’s New section (https://ncchildcare.ncdhhs.gov/Whats-New/north-carolina-early-childhood-equivalency-exam-now-available). It is vitally important that all employees are registered for WORKS and maintain their workforce information to support education requirements. We discussed that the facility is responsible for ensuring that information contained in the Early Childhood Education Workforce Database is up to date and complete. I encouraged you to study the information found on the Division’s website regarding education evaluations to ensure that staff member’s education information remains complete and to ensure accurate points are earned during Rated License Assessments. Keep in mind, it is expected that compliance with Education standards is maintained at all times, so you must ensure you monitor staff qualifications and percentages in advance of your upcoming reassessment. Documentation was completed on site, reviewed electronically, signed, and emailed to you. Remember it is your responsibility to comply with all child care rules and requirements at all times. Contact me at Tammy.Ross@dhhs.nc.gov at (910)824-1143 with any questions or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1703 · Violation

Name of Operation: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: TAMMY ROSS Operation Type: Center Case Number: Visit Date: 7/20/2023 Number Present: 51 Completed Date: 7/20/2023 Age: From 2 To 12 Total Minutes: 120 Time In: 10:00 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 routine unannounced visit was to monitor compliance with applicable child care requirements. Limited child care requirements pertinent to this visit type were monitored. Child Care Consultant, April Bosse, assisted with this visit. This facility currently operates with a Four Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted on December 21, 2022. This facility has an 18-month compliance history of 98%. Fire Inspection – November 21, 2022 - PASS Sanitation Inspection – May 23, 2023 – 8 Demerits – Superior Owner/Administrator, Steph Nestor, arrived as we were finishing up the visit. However, Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. Ms. Thacker accompanied Ms. Bosse as she completed a walkthrough of the facility. There are sixty-six children enrolled and fifty-one children, ages 2-11, were present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. The two-year-old and three-year-old children in space 6 and preschool children in Space 5 were engaged in group time reading various books the children chose, finishing morning snack provided by parents or engaged in activity areas with lacing and tying boards, blocks, geo rock collections and puzzles. Children in spaces 1 and 2 were observed in indoor spaces engaged in activity areas with blocks, dress-up clothing, coloring with colored pencils and small manipulative toys. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. During today's visit child care requirements monitored for compliance included supervision, staff/child ratio, CPR and First Aid, Criminal Record Checks, storage of hazardous substances and medications, approved space, licensing requirements, new staff and program records, posting of the license, and other applicable requirements. There were three violations documented today. All violation must be corrected immediately. Continued compliance with applicable child care requirements is required. Violation Number Comment Rule 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member hired July 17, 2023 had a TB screening on file that was older than 12 months. .0701(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. Two staff members whose First Aid expired in July 2023 and April 2023 did not successfully complete certification in First Aid before expiration of current certifications as it was not in the staff file. .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. Two staff members whose CPR expired in July 2023 and April 2023 did not complete certification in CPR training prior to expiration and was not available in staff files. .1102(d) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. This information was not available for four staff members during today's visit. .1103(b) In order for your facility to remain in compliance with NC Child Care Requirements, violations must be corrected immediately. A signed and dated letter of compliance must be received July 27, 2023 describing how each violation was corrected and how compliance will be maintained in the future. The time frame is established to allow you time for submitting your compliance letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. If I can be of further assistance, please do not hesitate to contact me at (910)824-1143 or you can email me at Tammy.Ross@dhhs.nc.gov. You may email me your verification or mail it to me at: Tammy Ross, Child Care Licensing Consultant, P.O. Box 278, Jacksonville, NC 28541 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. 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 of the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times whether or not they have been monitored or specifically discussed with you in the past. The best way for you to make sure that you are meeting all requirements is to periodically review the child care law and rules. Comments regarding violations cited today Health & Safety Training- These training topics outlined in Child Care Rule 10A NCAC 09 .1703(b) must be completed within the first year of employment for new staff, with the exception of Recognizing and Responding to Suspicions of Child Maltreatment – it must be completed within 90 days of hire. After initial completion of Health and Safety Trainings, they must be completed every five years. Use the Health and Safety Training Record which is found on the DCDEE website under Provider Documents and Forms to track the completion of these trainings. During today’s visit, four staff members did not have verification on file for renewing/completing Recognizing and Responding to Suspicions of Child Maltreatment. Completing, refreshing, and updating the required Health and Safety Training increases your awareness and knowledge regarding child development and safety. CPR/FA - All staff must have current CPR/FA at all times. These training for two staff members have expired. It expired for S. Nestor on July 4, 2023 and for B. Collins on April 16, 2023. CPR/FA training must be renewed immediately. TB skin test must be completed and on file from day one of employment. TB skin results must indicate staff member is free of active TB and/or TB test or screening must be less than 12 months. Technical Assistance: Permission to Administer Medication Form: Child Care Rule 10A NCAC 09 .0803 (8) ADMINISTERING MEDICATION IN CHILD CARE CENTERS states a parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. This form should accompany the action plan for a child where medication is required to be given. This form can be found on the DCDEE website under the provider documents. Locking Storage: Today we discussed reviewing sanitation rule 15A NCAC 18A .2820 STORAGE regarding storage and accessibility of potentially hazardous items with all staff as there are many cabinets that have child locks on them and not a lock that must be unlocked with a key or combination. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor and do not have to be locked. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as non-emergency medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Reviewing these rules with staff will ensure that products continue to be stored correctly. Storage of Emergency Medications: Today technical assistance was given regarding how to safely store emergency medication so that it is available if needed quickly. Child Care Rule 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT states designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol. Other Information: On March 13, 2023, the Military Child Care in Your Neighborhood-PLUS (MCCYN-PLUS) initiative launched in North Carolina to make it easier for military families to access and afford quality child care from community providers. Licensed child care facilities are now able to participate in MCCYN-PLUS based on their star rating. If you are interested in participating in the military fee assistance program, please visit https://www.childcareaware.org/fee-assistancerespite/feeassistancerespiteproviders/feeassistance/ to review the application process. Rated License Reassessment Information Your facility’s three-year rated license reassessment was due to be completed August 2023, but was not completed due to reassessments being voluntary during the COVID-19 pandemic. As discussed today, reassessments will not become mandatory again until July 1, 2024, and your facility has been placed into “Cohort 2.” Placement in this cohort means you will have from July 1, 2024 to June 30, 2025 to plan and prepare for your reassessment, with your reassessment being due between July 1, 2025 and June 30, 2026. In your planning year, you may review resources available at www.ncrlap.org and contact Smart Start of Pender County or Region 4 CCR&R for assistance with completion of the self-study component. I am also available to assist you upon request. This is an opportunity to focus on your Star Rated License and consider strategies to help maintain or increase your star rating. Use staff meetings to discuss topics related to the Environment Rating Scales or other quality initiatives. For example, if transitions are challenging, ask staff what strategies help, or which transitions including a contact hour earning webinar and Thinking More worksheets for every rating scale. Engage to brainstorm, offer support and clarification, and set goals. Allocate resources so they can focus on self-study as part of the workday to help everyone become more familiar and confident with the assessment process. Also, be reminded that you may voluntarily request a reassessment at any time by contacting me, and that NCRLAP outreach assessments may still being offered if you wish to “practice.” You may also wish to contact technical assistance specialists with One Place to help you with mock assessments. Related to education, ensure you are uploading education has staff completed classwork. For any questions about the NC Early Childhood Equivalency exam, please contact: DCDEE.Equivalency.Exam@dhhs.nc.gov. This information can also be found on the DCDEE website (https://ncchildcare.ncdhhs.gov/) under the What’s New section (https://ncchildcare.ncdhhs.gov/Whats-New/north-carolina-early-childhood-equivalency-exam-now-available). It is vitally important that all employees are registered for WORKS and maintain their workforce information to support education requirements. We discussed that the facility is responsible for ensuring that information contained in the Early Childhood Education Workforce Database is up to date and complete. I encouraged you to study the information found on the Division’s website regarding education evaluations to ensure that staff member’s education information remains complete and to ensure accurate points are earned during Rated License Assessments. Keep in mind, it is expected that compliance with Education standards is maintained at all times, so you must ensure you monitor staff qualifications and percentages in advance of your upcoming reassessment. Documentation was completed on site, reviewed electronically, signed, and emailed to you. Remember it is your responsibility to comply with all child care rules and requirements at all times. Contact me at Tammy.Ross@dhhs.nc.gov at (910)824-1143 with any questions or concerns. 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 .1719 · Violation

Name of Operation: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: TAMMY ROSS Operation Type: Center Case Number: Visit Date: 7/20/2023 Number Present: 51 Completed Date: 7/20/2023 Age: From 2 To 12 Total Minutes: 120 Time In: 10:00 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 routine unannounced visit was to monitor compliance with applicable child care requirements. Limited child care requirements pertinent to this visit type were monitored. Child Care Consultant, April Bosse, assisted with this visit. This facility currently operates with a Four Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted on December 21, 2022. This facility has an 18-month compliance history of 98%. Fire Inspection – November 21, 2022 - PASS Sanitation Inspection – May 23, 2023 – 8 Demerits – Superior Owner/Administrator, Steph Nestor, arrived as we were finishing up the visit. However, Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. Ms. Thacker accompanied Ms. Bosse as she completed a walkthrough of the facility. There are sixty-six children enrolled and fifty-one children, ages 2-11, were present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. The two-year-old and three-year-old children in space 6 and preschool children in Space 5 were engaged in group time reading various books the children chose, finishing morning snack provided by parents or engaged in activity areas with lacing and tying boards, blocks, geo rock collections and puzzles. Children in spaces 1 and 2 were observed in indoor spaces engaged in activity areas with blocks, dress-up clothing, coloring with colored pencils and small manipulative toys. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. During today's visit child care requirements monitored for compliance included supervision, staff/child ratio, CPR and First Aid, Criminal Record Checks, storage of hazardous substances and medications, approved space, licensing requirements, new staff and program records, posting of the license, and other applicable requirements. There were three violations documented today. All violation must be corrected immediately. Continued compliance with applicable child care requirements is required. Violation Number Comment Rule 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member hired July 17, 2023 had a TB screening on file that was older than 12 months. .0701(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. Two staff members whose First Aid expired in July 2023 and April 2023 did not successfully complete certification in First Aid before expiration of current certifications as it was not in the staff file. .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. Two staff members whose CPR expired in July 2023 and April 2023 did not complete certification in CPR training prior to expiration and was not available in staff files. .1102(d) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. This information was not available for four staff members during today's visit. .1103(b) In order for your facility to remain in compliance with NC Child Care Requirements, violations must be corrected immediately. A signed and dated letter of compliance must be received July 27, 2023 describing how each violation was corrected and how compliance will be maintained in the future. The time frame is established to allow you time for submitting your compliance letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. If I can be of further assistance, please do not hesitate to contact me at (910)824-1143 or you can email me at Tammy.Ross@dhhs.nc.gov. You may email me your verification or mail it to me at: Tammy Ross, Child Care Licensing Consultant, P.O. Box 278, Jacksonville, NC 28541 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. 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 of the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times whether or not they have been monitored or specifically discussed with you in the past. The best way for you to make sure that you are meeting all requirements is to periodically review the child care law and rules. Comments regarding violations cited today Health & Safety Training- These training topics outlined in Child Care Rule 10A NCAC 09 .1703(b) must be completed within the first year of employment for new staff, with the exception of Recognizing and Responding to Suspicions of Child Maltreatment – it must be completed within 90 days of hire. After initial completion of Health and Safety Trainings, they must be completed every five years. Use the Health and Safety Training Record which is found on the DCDEE website under Provider Documents and Forms to track the completion of these trainings. During today’s visit, four staff members did not have verification on file for renewing/completing Recognizing and Responding to Suspicions of Child Maltreatment. Completing, refreshing, and updating the required Health and Safety Training increases your awareness and knowledge regarding child development and safety. CPR/FA - All staff must have current CPR/FA at all times. These training for two staff members have expired. It expired for S. Nestor on July 4, 2023 and for B. Collins on April 16, 2023. CPR/FA training must be renewed immediately. TB skin test must be completed and on file from day one of employment. TB skin results must indicate staff member is free of active TB and/or TB test or screening must be less than 12 months. Technical Assistance: Permission to Administer Medication Form: Child Care Rule 10A NCAC 09 .0803 (8) ADMINISTERING MEDICATION IN CHILD CARE CENTERS states a parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. This form should accompany the action plan for a child where medication is required to be given. This form can be found on the DCDEE website under the provider documents. Locking Storage: Today we discussed reviewing sanitation rule 15A NCAC 18A .2820 STORAGE regarding storage and accessibility of potentially hazardous items with all staff as there are many cabinets that have child locks on them and not a lock that must be unlocked with a key or combination. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor and do not have to be locked. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as non-emergency medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Reviewing these rules with staff will ensure that products continue to be stored correctly. Storage of Emergency Medications: Today technical assistance was given regarding how to safely store emergency medication so that it is available if needed quickly. Child Care Rule 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT states designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol. Other Information: On March 13, 2023, the Military Child Care in Your Neighborhood-PLUS (MCCYN-PLUS) initiative launched in North Carolina to make it easier for military families to access and afford quality child care from community providers. Licensed child care facilities are now able to participate in MCCYN-PLUS based on their star rating. If you are interested in participating in the military fee assistance program, please visit https://www.childcareaware.org/fee-assistancerespite/feeassistancerespiteproviders/feeassistance/ to review the application process. Rated License Reassessment Information Your facility’s three-year rated license reassessment was due to be completed August 2023, but was not completed due to reassessments being voluntary during the COVID-19 pandemic. As discussed today, reassessments will not become mandatory again until July 1, 2024, and your facility has been placed into “Cohort 2.” Placement in this cohort means you will have from July 1, 2024 to June 30, 2025 to plan and prepare for your reassessment, with your reassessment being due between July 1, 2025 and June 30, 2026. In your planning year, you may review resources available at www.ncrlap.org and contact Smart Start of Pender County or Region 4 CCR&R for assistance with completion of the self-study component. I am also available to assist you upon request. This is an opportunity to focus on your Star Rated License and consider strategies to help maintain or increase your star rating. Use staff meetings to discuss topics related to the Environment Rating Scales or other quality initiatives. For example, if transitions are challenging, ask staff what strategies help, or which transitions including a contact hour earning webinar and Thinking More worksheets for every rating scale. Engage to brainstorm, offer support and clarification, and set goals. Allocate resources so they can focus on self-study as part of the workday to help everyone become more familiar and confident with the assessment process. Also, be reminded that you may voluntarily request a reassessment at any time by contacting me, and that NCRLAP outreach assessments may still being offered if you wish to “practice.” You may also wish to contact technical assistance specialists with One Place to help you with mock assessments. Related to education, ensure you are uploading education has staff completed classwork. For any questions about the NC Early Childhood Equivalency exam, please contact: DCDEE.Equivalency.Exam@dhhs.nc.gov. This information can also be found on the DCDEE website (https://ncchildcare.ncdhhs.gov/) under the What’s New section (https://ncchildcare.ncdhhs.gov/Whats-New/north-carolina-early-childhood-equivalency-exam-now-available). It is vitally important that all employees are registered for WORKS and maintain their workforce information to support education requirements. We discussed that the facility is responsible for ensuring that information contained in the Early Childhood Education Workforce Database is up to date and complete. I encouraged you to study the information found on the Division’s website regarding education evaluations to ensure that staff member’s education information remains complete and to ensure accurate points are earned during Rated License Assessments. Keep in mind, it is expected that compliance with Education standards is maintained at all times, so you must ensure you monitor staff qualifications and percentages in advance of your upcoming reassessment. Documentation was completed on site, reviewed electronically, signed, and emailed to you. Remember it is your responsibility to comply with all child care rules and requirements at all times. Contact me at Tammy.Ross@dhhs.nc.gov at (910)824-1143 with any questions or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: RAINBOW GARDEN PRESCHOOL & EXTENDED CARE Facility ID: 71000232 Consultant: TAMMY ROSS Operation Type: Center Case Number: Visit Date: 7/20/2023 Number Present: 51 Completed Date: 7/20/2023 Age: From 2 To 12 Total Minutes: 120 Time In: 10:00 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 routine unannounced visit was to monitor compliance with applicable child care requirements. Limited child care requirements pertinent to this visit type were monitored. Child Care Consultant, April Bosse, assisted with this visit. This facility currently operates with a Four Star License reissued August 26, 2020, earning 6 points in Education and 4 points in Program Standards. Restrictions on the permit include: an age range of 2-12 with a first shift capacity of 110, meeting enhanced ratios, no cooking allowed in building, and SA Bldg. B – capacity of 50. According to the Secretary of State’s website, the corporation’s status, Cape Fear Child Development Center, is current and active. The last annual compliance visit was conducted on December 21, 2022. This facility has an 18-month compliance history of 98%. Fire Inspection – November 21, 2022 - PASS Sanitation Inspection – May 23, 2023 – 8 Demerits – Superior Owner/Administrator, Steph Nestor, arrived as we were finishing up the visit. However, Lindsey Thacker, Lead Teacher/Assistant Director was present and available for consultation. Ms. Thacker accompanied Ms. Bosse as she completed a walkthrough of the facility. There are sixty-six children enrolled and fifty-one children, ages 2-11, were present today. All approved indoor and outdoor spaces were monitored today. Daily schedules were available for each group of children. Activity plans were observed posted in each classroom. A variety of age-appropriate learning materials was observed in each classroom. The two-year-old and three-year-old children in space 6 and preschool children in Space 5 were engaged in group time reading various books the children chose, finishing morning snack provided by parents or engaged in activity areas with lacing and tying boards, blocks, geo rock collections and puzzles. Children in spaces 1 and 2 were observed in indoor spaces engaged in activity areas with blocks, dress-up clothing, coloring with colored pencils and small manipulative toys. Lunch is provided from home for each child. Adequate supervision and positive interactions were observed throughout. During today's visit child care requirements monitored for compliance included supervision, staff/child ratio, CPR and First Aid, Criminal Record Checks, storage of hazardous substances and medications, approved space, licensing requirements, new staff and program records, posting of the license, and other applicable requirements. There were three violations documented today. All violation must be corrected immediately. Continued compliance with applicable child care requirements is required. Violation Number Comment Rule 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member hired July 17, 2023 had a TB screening on file that was older than 12 months. .0701(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. Two staff members whose First Aid expired in July 2023 and April 2023 did not successfully complete certification in First Aid before expiration of current certifications as it was not in the staff file. .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. Two staff members whose CPR expired in July 2023 and April 2023 did not complete certification in CPR training prior to expiration and was not available in staff files. .1102(d) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. This information was not available for four staff members during today's visit. .1103(b) In order for your facility to remain in compliance with NC Child Care Requirements, violations must be corrected immediately. A signed and dated letter of compliance must be received July 27, 2023 describing how each violation was corrected and how compliance will be maintained in the future. The time frame is established to allow you time for submitting your compliance letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. If I can be of further assistance, please do not hesitate to contact me at (910)824-1143 or you can email me at Tammy.Ross@dhhs.nc.gov. You may email me your verification or mail it to me at: Tammy Ross, Child Care Licensing Consultant, P.O. Box 278, Jacksonville, NC 28541 Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. 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 of the licensing requirements that apply to your type of program. It is your responsibility to maintain compliance with all of the applicable laws and rules at all times whether or not they have been monitored or specifically discussed with you in the past. The best way for you to make sure that you are meeting all requirements is to periodically review the child care law and rules. Comments regarding violations cited today Health & Safety Training- These training topics outlined in Child Care Rule 10A NCAC 09 .1703(b) must be completed within the first year of employment for new staff, with the exception of Recognizing and Responding to Suspicions of Child Maltreatment – it must be completed within 90 days of hire. After initial completion of Health and Safety Trainings, they must be completed every five years. Use the Health and Safety Training Record which is found on the DCDEE website under Provider Documents and Forms to track the completion of these trainings. During today’s visit, four staff members did not have verification on file for renewing/completing Recognizing and Responding to Suspicions of Child Maltreatment. Completing, refreshing, and updating the required Health and Safety Training increases your awareness and knowledge regarding child development and safety. CPR/FA - All staff must have current CPR/FA at all times. These training for two staff members have expired. It expired for S. Nestor on July 4, 2023 and for B. Collins on April 16, 2023. CPR/FA training must be renewed immediately. TB skin test must be completed and on file from day one of employment. TB skin results must indicate staff member is free of active TB and/or TB test or screening must be less than 12 months. Technical Assistance: Permission to Administer Medication Form: Child Care Rule 10A NCAC 09 .0803 (8) ADMINISTERING MEDICATION IN CHILD CARE CENTERS states a parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. This form should accompany the action plan for a child where medication is required to be given. This form can be found on the DCDEE website under the provider documents. Locking Storage: Today we discussed reviewing sanitation rule 15A NCAC 18A .2820 STORAGE regarding storage and accessibility of potentially hazardous items with all staff as there are many cabinets that have child locks on them and not a lock that must be unlocked with a key or combination. Items labeled “Keep out of reach of children” with no other warnings must be stored at a minimum of five feet off the floor and do not have to be locked. Hazardous cleaning supplies, including those kept under pressure in an aerosol can, as well as non-emergency medications must be kept in locked storage. The definition of locked storage requires that the lock be unlocked with some type of device such as a key or combination. Regular childproofing locks do not meet this requirement. Reviewing these rules with staff will ensure that products continue to be stored correctly. Storage of Emergency Medications: Today technical assistance was given regarding how to safely store emergency medication so that it is available if needed quickly. Child Care Rule 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT states designated emergency medications shall be stored out of reach of children at least five feet high, but are not required to be in locked storage. For purposes of this Rule, designated emergency medications are those that are used or needed for the immediate recovery from a life-threatening event and include Glucagon, epinephrine auto-injector, diazepam rectal installation and albuterol. Other Information: On March 13, 2023, the Military Child Care in Your Neighborhood-PLUS (MCCYN-PLUS) initiative launched in North Carolina to make it easier for military families to access and afford quality child care from community providers. Licensed child care facilities are now able to participate in MCCYN-PLUS based on their star rating. If you are interested in participating in the military fee assistance program, please visit https://www.childcareaware.org/fee-assistancerespite/feeassistancerespiteproviders/feeassistance/ to review the application process. Rated License Reassessment Information Your facility’s three-year rated license reassessment was due to be completed August 2023, but was not completed due to reassessments being voluntary during the COVID-19 pandemic. As discussed today, reassessments will not become mandatory again until July 1, 2024, and your facility has been placed into “Cohort 2.” Placement in this cohort means you will have from July 1, 2024 to June 30, 2025 to plan and prepare for your reassessment, with your reassessment being due between July 1, 2025 and June 30, 2026. In your planning year, you may review resources available at www.ncrlap.org and contact Smart Start of Pender County or Region 4 CCR&R for assistance with completion of the self-study component. I am also available to assist you upon request. This is an opportunity to focus on your Star Rated License and consider strategies to help maintain or increase your star rating. Use staff meetings to discuss topics related to the Environment Rating Scales or other quality initiatives. For example, if transitions are challenging, ask staff what strategies help, or which transitions including a contact hour earning webinar and Thinking More worksheets for every rating scale. Engage to brainstorm, offer support and clarification, and set goals. Allocate resources so they can focus on self-study as part of the workday to help everyone become more familiar and confident with the assessment process. Also, be reminded that you may voluntarily request a reassessment at any time by contacting me, and that NCRLAP outreach assessments may still being offered if you wish to “practice.” You may also wish to contact technical assistance specialists with One Place to help you with mock assessments. Related to education, ensure you are uploading education has staff completed classwork. For any questions about the NC Early Childhood Equivalency exam, please contact: DCDEE.Equivalency.Exam@dhhs.nc.gov. This information can also be found on the DCDEE website (https://ncchildcare.ncdhhs.gov/) under the What’s New section (https://ncchildcare.ncdhhs.gov/Whats-New/north-carolina-early-childhood-equivalency-exam-now-available). It is vitally important that all employees are registered for WORKS and maintain their workforce information to support education requirements. We discussed that the facility is responsible for ensuring that information contained in the Early Childhood Education Workforce Database is up to date and complete. I encouraged you to study the information found on the Division’s website regarding education evaluations to ensure that staff member’s education information remains complete and to ensure accurate points are earned during Rated License Assessments. Keep in mind, it is expected that compliance with Education standards is maintained at all times, so you must ensure you monitor staff qualifications and percentages in advance of your upcoming reassessment. Documentation was completed on site, reviewed electronically, signed, and emailed to you. Remember it is your responsibility to comply with all child care rules and requirements at all times. Contact me at Tammy.Ross@dhhs.nc.gov at (910)824-1143 with any questions or concerns. 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