Atkinson Psam-Pspm-Plus

10A NCAC 09 .0802 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0607 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0801 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0802 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0803 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.1104 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/9/2026 Number Present: 6 Completed Date: 2/9/2026 Age: From 5 To 9 Total Minutes: 160 Time In: 02:35 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. A signed copy of the visit summary was left on-site with to you. Beverly Myers, Substitute, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/6/2026. This school age program operated by Henderson County Public Schools, is located in Atkinson Elementary School. Permit type – Five (5) Star Center License, issued 8/27/2025. Special Services/Restrictions – first shift, school age only, meets enhanced space, meets reduced ratios, group size by one from the 7pt level. The last annual compliance visit was conducted on 2/17/2025. The last fire drill was practiced on 1/21/2026. The last lockdown drill was practiced on 11/20/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care plan was posted and current. During the previous visit 8/27/2025, we discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Today, I reviewed the EMC plan and the emergency contact/alternate person. Ms. Myers was unsure where the documentation for the alternate person information was located. However, she does contact Sonya Hall or Stephanie Edney who is listed at the alternate person on the EMC plan by phone or text. We also discussed that the staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. The program does not provide transportation. During the visit, I observed the group with five- to nine-year-old children entering the cafeteria at 2:55p put belongings away in blue tubs and got hand sanitizer while they waited on everyone to arrive. Once everyone arrived, at 2:57p the group lined up to transition to the restroom and wash hands. At 3:00p the group arrived back a the cafeteria for snack. Snack consisted of chex mix, and milk. After snack, the children transitioned to free play with barbie dolls, free art, gears, uno, checkers. Then transitioned to the mobile unit, and outdoors for gross motor play. Staff and children’s files were monitored. We discussed the administrators qualifying letter will expire on 3/4/2026. The administrator will need to begin the background check process immediately. Please note, if the letter is not renewed by the expiration date a violation will be cited during the next monitoring visit. Also, as discussed during the previous visit on 8/27/2025, the ABCMS portal should reflect the staff currently assigned to this site. The current staff roster should include the administrator and any routine staff members or substitutes. Currently, the only staff member listed is the program coordinator. Staff professional development plans were not completed annually, the professional development plans on file were dated 8/6/2024 and 1/29/2025. We discussed preplanning the days these plans will be reviewed in order to prevent a reoccurrence. While reviewing medications, I observed one (1) emergency medication that expired 12/2025, one (1) medical action plan was not on file for review, and one (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Quality Rating and Improvement System (QRIS): The program coordinator was out today, and the substitute was unsure which pathway the facility wishes to pursue. We discussed that the Child Care Coordinator and Program Coordinator will need to contact me to schedule a technical assistance visit by February 28, 2026. A technical assistance visit will be an announced visit to discuss the QRIS pathways. An email was sent on 2/5/2026, to Sonya Hall, Child Care Coordinator with Henderson County Public Schools, requesting that a meeting be scheduled. Reminder a pathway must be select no later than March 31, 2026, and the star rated licenses must be reassessed by 12/31/2026. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. .0802(a)(1)(A-B); 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One (1) emergency medication that was missing the original pharmacy label. .0803(2)(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. One (1) emergency medication that expired 12/2025. .0803(12) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. 10A NCAC 09 .0802(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. G.S. 110-90.2 & .2703(r) 1826 Substitutes and volunteers counted in ratio were not informed of the center's EPR Plan and its location. Documentation of this notice was not maintained on file or in a file designated for emergency preparedness and response plan documents. Substitute staff file did not maintain documentation of the EPR plan review. .0607(g) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. .0801(b) 1902 The professional development plan was not reviewed annually. Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. .1104 Technical assistance was provided as follows: Item 837- The staff present during today’s visit was not listed on the Emergency Medical Care plan as the person responsible in the event of an emergency. We discussed if only one (1) staff member is needed to provide care a substitute or another routine staff member will need to be listed as the responsible person on-site when the program coordinator is out. Rule Reference: 10A NCAC 09.0802(a) Item 844- One (1) emergency medication that was missing the original pharmacy label. We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09 .0803(2)(a) Item 849- One (1) emergency medication that expired 12/2025.We discussed conducting a monthly medication check to ensure medication requirements are met. Rule reference: 10A NCAC 09.0803(12) Item 862- Emergency Medical Care (EMC) plan review was not conducted annually. The last EMC plan review was completed on 8/8/2024, and the substitute staff did not have a EMC plan review on file for Atkinson PSPM. We discussed having a blank copy of the EMC plan review ready at the beginning of the year for staff to completed once the plan has been reviewed with them. Rule Reference: 10A NCAC 09 .0802(a) Item 1805- Child Care operator did not notify the Division of any new child care providers who were hired or moved into the facility within five (5) business days. Staff member hired 1/10/2000 and the administrator was not listed in the ABCMS portal. We discussed that all staff should be listed and as new staff are hired or terminated, the roster should be updated. Rule Reference: G.S. 110-90.2 & .2703(r) New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Item 1826- Substitute staff file did not maintain documentation of the EPR plan review. We discussed for substitute staff and routine staff member to review the EPR plan and have documentation on site for review. Rule Reference: 10A NCAC 09.0607(g) Item 1834- One (1) medical action plan was not attached to the child’s application. Child enrolled 8/6/2025 did not have a medical action plan on file for review. We discussed staff reviewing medication paper to ensure a medical action plan is on file for each child that requires an emergency medication on-site. Rule Reference: 10A NCAC 09.0801(b) Item 1902- Staff professional development plans were not reviewed annually. The last professional development plan on file was dated 8/6/2024, and 1/29/2025. We discussed to select a day to complete all professional development plans annually to ensure plans are completed. Rule Reference: 10A NCAC 09.1104 Achieving Compliance Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 2/23/2026. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952 or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: -We discussed the facility ABCMS portal is being updated, the facility will need to ensure the administrator and substitute staff are listed on the employee roster. -We discussed conducting a monthly medication check to ensure all medication requirements are met. -Professional development plans are staff evaluations are due to be conducted annually. The substitute staff evaluation is due to be completed by 3/4/2026. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 8/27/2025 Number Present: 14 Completed Date: 8/27/2025 Age: From 5 To 10 Total Minutes: 155 Time In: 02:55 PM Time Out: 05:30 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 your program for compliance with applicable child care requirements for a routine unannounced visit. A handwritten report of today’s visit was completed due to connectivity, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator during the visit. A signed copy of the visit summary was left on-site with you. Upon arrival, I was greeted by Kristine Krepela, Program Coordinator. Ms. Krepela accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/17/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions This school-age program, operated by Henderson County Public Schools, is located in a public-school building. Permit type – Five (5) Star Rated License, issued 2/26/2020. Special Services/Restrictions – First shift (Daytime care), school-age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one from 7-point level. During today’s visit, we discussed and removed the restriction playground does not meet NC child care licensing safety requirement per Session Law 2025-36. The last fire drill was practiced on 8/19/2025. The last emergency drill, lockdown drill, was practiced on 8/26/2025. The next emergency drill is due by 11/26/2025. The last lead water test was completed on 5/20/2024. The next testing is due by 5/20/2027. The last lead paint was completed on 8/12/2024. The Clean Classrooms for Carolina Kids™ team determined that Atkinson Elementary was exempt from the lead-based paint assessment requirements. The facility provided the appropriate documentation to show all buildings were built after 1978 and no lead-based paint was used in order to meet the building age exemption criteria per 10A NCAC 41C.1004.No additional action is required by the facility. The Emergency Medical Care Plan is posted and was updated 1/3/2024. We discussed that the Emergency Medical care plan is to be reviewed and updated annually. We also discussed that since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. The program does not provide transportation. During today's visit, a walkthrough of the indoor and outdoor environment was conducted. The children began arriving at 2:55p as they entered the cafeteria, the children signed in and were given hand sanitizer until the group was able to go to the restroom. After signing in the children put their belongings away in individual totes and began free play at the tables. Once all the children arrived, the group of five-to-ten-year-old children lined up and transitioned to the restroom. The children used the restroom and washed their hands to prepare for snack. The group transitioned back to the cafeteria. When they arrived back in the cafeteria, the program coordinator distributed snacks and the children sat at the table. As the children finished snack, they were given hand sanitizer and transitioned to free play at the tables with animals, knex, drawing, scramble game, and dolls. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. All medications were monitored and met requirements. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. 10A NCAC 09 .0901(b) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. 10A NCAC 09 .0802(a) Technical assistance was provided as follows: Item 528 Snack today consisted of Lucky Charms and milk. The menu posted documented Trix and milk. The program coordinator did not update menu to document the snack substitutions prior to serving the children. We discussed when you are aware of any snack substitutions, the substitutions must be documented on the menu prior to serving to the children. Rule Reference: 10A NCAC 09 .0901(b) Item 862 The Emergency Medical Care (EMC) Plan was not reviewed and updated annually. The EMC was updated last on 1/3/2024. We discussed that the Emergency Medical Care plan is to be reviewed and updated annually. We also discussed since Ms. Krepela is the only staff member on-site, the person who agreed to be the emergency contact/alternate person must have their name, address, phone number and a statement on file agreeing to be the emergency contact/alternate person in the event of an emergency. Rule Reference: 10A NCAC 09 .0802(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 9/10/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders: Staff member WR criminal background check qualification letter will expire on 3/6/2026. Asbestos testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing was required to be completed by May 31, 2025. Continue to work closely with the school system to complete the asbestos portion of the testing. Ms. Krepela stated that the school has completed the testing, but the school system has the test results. I stated that she will need to request a copy to have on file for review. ABCMS roster: I reviewed the program roster on the ABCMS system prior to this visit. No employees are listed on the roster. The administrator has completed the ABCMS portal training and is currently working on learning how to use the portal to update the roster. All existing and new staff must be listed. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. QRIS Modernization: We discussed the new QRIS pathways to the stars. I asked the provider to begin looking at which pathway they want to pursue. During the next unannounced visit, we will discuss which pathway they have chosen and begin planning and discussing next steps. Today, I encouraged the provider to visit the Divisions website https://ncchildcare.ncdhhs.gov/ to access the Quality Rating Improvement System (QRIS) Modernization page to review each pathway and the supporting resources. DCDEE MOODLE: DCDEE has added a new training module about Child Development on the DCDEE Moodle Learning Platform. This is the first of several planned modules to support orientation and the health and safety training requirements. This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID is needed to access the Child Development Module. If you do not have an NCID, visit MYNCID.nc.gov to register for a free NCID account. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0607 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0803 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.2703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/17/2025 Number Present: 15 Completed Date: 2/17/2025 Age: From 5 To 11 Total Minutes: 165 Time In: 02:45 PM Time Out: 05:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Kristine Krepela, Program Coordinator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Kristine Krepela, Program Coordinator, was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-four percent (84%) as of 2/14/2025. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The last annual compliance visit was conducted on 2/27/2024. The last fire drill was practiced on 1/16/2025. A monthly fire drill was missed for October and November due to Tropical Storm Helene. Since the facility has re-opened, the facility has resumed monthly fire drills. The last lockdown drill was practiced on 1/28/2025. The last fire inspection was approved on 8/7/2024. The last sanitation inspection was conducted on 8/29/2024 with two (2) demerits for a superior classification. The last lead water test was conducted on 5/20/2024. However, lead paint and asbestos testing is still due to be completed by 5/31/2025. The Emergency Medical Care plan was posted and current. The facility was closed from 9/27/2024 to 12/9/2024 due to the significant damages sustained from Tropical Storm Helene. The program absorbed the children enrolled in other licensed sites until the program was able to reopen at it’s original location. During today's visit, I was greeted by the Program Coordinator and Group Lead in the modular unit. The children began arriving at 2:55p in the cafeteria. The group of children ages five to eleven years old arrived in the cafeteria and put their belongings away. Then the group lined up and transitioned to the restroom. After using the restroom and washing hands the group returned to the cafeteria for snack. When the children finished snack, they got hand sanitizer and transitioned to free play at the tables with magnetic tiles, Barbies, Lincoln logs, legos, and worked on homework. While monitoring the mobile unit, I observed the activity plans not posted. As I discussed this with the Program Coordinator, she stated that the printer began smoking while attempting print before the children arrived, and she quickly unplugged the printer. She was able to show the current activity plans to me on the computer. Snack today consisted of Cheez-its and milk. All medications were monitored. One (1) epi pen expired 11/2024 and one medication form will expired on 2/21/2025. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. We discussed that one (1) permission to administer medication form will expire on 2/21/2025 and the parent will need to update the permission to administer medication form. While reviewing the Emergency Preparedness and Response Plan, I noticed that the EPR plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated, and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to remind her when to update the EPR plan. The staff and training worksheet was received prior to today’s visit. Staff file concerns were observed. Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she would need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. . The program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 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. One (1) epi pen expired 11/2024. .0803(12) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & .2703(n)&(o) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member M. Moore criminal background check expired 11/14/2024. G.S. 110-90.2(b) & (d) & .2703(e) 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 Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. .0607(e) Technical assistance was provided as follows: Item 849- One (1) epi pen expired 11/2024. When I asked about these the Program Coordinator stated that the parent was aware that the epi pen expired 11/2024, but the doctor would prescribe the child another epi pen until the child was seen in the office. The child has an appointment this month. We discussed that the epi pen would not be able to be used at the facility. The parent would need to bring in an epi pen that has not expired or discuss a plan for if the child has an allergic reaction while at the facility. Rule Reference: 10A NCAC 09.0803(12) Item 1044- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. Rule Reference: 10A NCAC 09.2703(n)&(o) Item 1757- Staff member M. Moore criminal background check expired 11/14/2024. We discussed that she will need to leave at the end of the day and cannot return until the letter has been updated. Ms. Moore left for the day at 4:15p. The violation must be corrected within two (2) weeks and that a copy of the qualification letter be mailed to the consultant with the required compliance letter. Rule Reference: 10A NCAC 09.2703(e) Item 1824- The Emergency Preparedness and Response Plan on file was not reviewed and updated annually. The plan was dated 1/12/2024 and was due to be updated on 1/12/2025. We discussed that the plan was due to be updated and the Program Coordinator stated that she would get that updated. I recommended that the Program Coordinator put that on her calendar to reminder her when to update the EPR plan. Rule Reference: 10A NCAC 09.0607(e) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/3/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: We discussed that staff member MM First Aid and CPR training will expire 4/22/2025. It is best to go ahead and register for your training. Review medications monthly to ensure that the medications and forms are still in compliance and note when they are due to be updated. Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 7 Completed Date: 9/4/2024 Age: From 5 To 8 Total Minutes: 150 Time In: 02:45 PM Time Out: 05:15 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Kristine Krepela, Program Coordinator. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. Kristine Krepela, Program Coordinator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 2/27/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The children began arriving in the cafeteria at 2:55p. Upon arrival into the cafeteria, the Program Coordinator greeted the children and gave them hand sanitizer. After getting hand sanitizer, the children put their belongings away in their individual tote, and then transitioned to free play until all the children arrived. Once all the children arrived, the group lined up and transitioned to the restroom down the hallway. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. After the children finished using the restroom the group lined up and transitioned back to the cafeteria. In the cafeteria the children were served snack. As the children finished snack, they got hand sanitizer and transitioned to free play until everyone was finished with snack. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. When all the children were finished with snack, the group lined up and transitioned to the restroom before relocating to the mobile unit. Once in the mobile unit, the children put their belongings away and went to free play with free art, blocks, and puzzles. Snack today consisted of cinnamon toast crunch cereal and milk. The last fire drill was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a fire drill. I stated that both programs must complete a fire drill because we do not know when a fire will happen, and we want everyone to know what to do. The last emergency drill, shelter in place drill, was practiced on 8/30/2024. When asked about PSAM, she stated that they have not conducted a emergency drill. I stated that both programs must complete a emergency drill because we do not know when a intruder or tornado will occur, and we want everyone to know what to do. The last fire inspection was approved on 8/7/2024. I received the updated fire inspection during the visit. The program’s most recent sanitation inspection was completed on 8/29/2024, with two (2) demerits. New inspection was received during the visit. The Emergency Medical Care Plan is posted and was updated in 1/3/2024. The program has two (2) prescription medications on-site. Both medications were monitored and were out of compliance with child care requirements. Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two (2) prescription medications were observed not in the original pharmacy labeled container. .0803(2)(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. .1103(a) 9995 A violation was found for which there is no item number. While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. The door was closed by the cafeteria staff at 3:15p Technical assistance was provided as follows: Item 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Rule Reference: 15A NCAC 18A.2820(b) While monitoring the restroom area, a custodian cart was observed unattended with a mop bucket with solution, chemicals in spray bottles and aerosol cans. When asked if they could put the cart in the custodian closet, she stated no. They discussed with the school last year about the custodian putting the cart up prior to the group using the restroom but was told no. She stated that she just makes sure that the children do not touch the custodian cart. We discussed that the cart must be locked, or someone must be with the cart at all times due to the hazardous products observed on the cart. If the school is unable to lock the cart, I suggest using another restroom that is not located to the custodian closet to ensure that the custodian cart is not accessible to the children. Item 844 Prescribed medicine was not in original pharmacy labeled container. Rule Reference: 10A NCAC 09 .0803(2)(a) ADMINISTERING MEDICATION IN CHILD CARE CENTERS Two (2) prescription medications were observed not in the original pharmacy labeled container. I discussed with the program coordinator that both medications must have a pharmacy label so that we are aware this is the appropriate dose for the child, and the medication is truly prescribed for the child. The parents will need to send in the original box with the pharmacy label or have the pharmacy print a new label to bring in. We also discussed that the permission to administer medication form must be reviewed every six (6) months to ensure that there have been no changes to the child’s medication. I suggest that you conduct a monthly medication check to review expiration dates of medications, permission to administer medication forms, and to ensure that the medications are stored in the original containers. Item 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Rule Reference: 10A NCAC 09 .1103 (a) ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT While reviewing staff files, staff member hired 6/6/2014 on-going training hours for the 2023-2024 were not completed in full. The staff member had five (5) of the required fifteen (15) training hours. We discussed that the staff member will need to complete ten (10) training hours with in two (2) weeks if the staff member will be working at this site during this school year. I suggest that you track each staff members training hours on a log to ensure that each staff member has completed the appropriate training number of training hours prior to their employment anniversary date. Item 9995 A violation was found for which there is no item number. The kitchen door was open giving the children access to the hot water, and kitchen equipment. Rule Reference: 15A NCAC 18A .2815 WATER SUPPLY While monitoring the cafeteria space at 3:09p, I observed the cafeteria door open with the hot water accessible to the children. We discussed the need for the door to be closed prior to the children using the cafeteria space so that a child does not sneak off to the kitchen space and access the hot water. She stated that she has to access the pass-through window, and the cafeteria staff close the door when they leave for the day. The door was closed by the cafeteria staff at 3:15p. PSAM-PSPM-PLUS staff will need to ensure that the kitchen door is locked and shut prior to the children entering the cafeteria to prevent any unexpected injuries. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 9/18/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Reminders -Staff member hired 10/18/2023 Health and Safety trainings is due by 10/18/2024. -Staff member hired 6/6/2014 Criminal Background Check is due by 11/14/2024. -Hold harmless has been extended until the new QRIS is implemented (SB 425). This means providers in Cohort 1 are not required to go any further with a rated license assessment unless they want to, and providers in Cohort 2 do not need to start their preparation year. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2510 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 2/27/2024 Number Present: 6 Completed Date: 2/27/2024 Age: From 6 To 10 Total Minutes: 150 Time In: 03:15 PM Time Out: 05:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Mary Moore, Sub/Group Leader, during the visit. The visit summary was signed and left on-site with you. Upon arrival, I was greeted by Mary Moore, Sub/Group Leader. Ms. Moore was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The program operates with a Five Star Rated License, issued 2/26/2020. The permit restrictions were in compliance including First shift (daytime care), school age only, meets enhanced space, meets reduced ratios; playground does not meet NC child care licensing safety requirements. Meets reduced group size by one (1) from seven (7) point level. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six percent (86%) as of 2/26/2024. This school age program, operated by Henderson County Public Schools, is located in a public-school building. The last annual compliance visit was conducted on 3/8/2023. The last fire drill was practiced on 1/8/2024. The last lockdown drill was practiced on 8/29/2023. The last fire inspection was approved on 1/4/2024 The last sanitation inspection was conducted on 12/8/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response (EPR) plan was up to date and current. Upon arrival, I introduced myself to Mary Moore, Sub/Group Leader. When I arrived, the children were cleaning up from snack and preparing to transition to the restroom. After using the restroom, the group transitioned to the mobile unit for free choice centers. The children engaged in play with play dough, art, and cozy area. While monitoring the mobile unit, I observed a closet that stored hazardous products unlocked. I asked the staff member about the lock and she stated it is typically locked. I monitored the emergency drill log and observed that a emergency drill has not been conducted since 8/29/2023. Snack consisted of cheez-its and milk. All medications were monitored and meet requirement. The staff and training worksheet was received prior to today's visit. One (1) new staff file was monitored. One (1) existing staff file was monitored. Staff file concerns were observed. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The report on file was dated 1/30/2015. BSAC training for staff member KK was completed late. Training was due by 1/18/2024 and training certificate documented 1/21/2024. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol can of Microban and chemicals in unlocked closet. .2820(b) 853 Incident logs were not completed and maintained as required. Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. .0802(g)(1-6) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. 10A NCAC 09 .0701(a) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. .0604(u);.0302(d)(8) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. .2510(j) Technical assistance was provided as follows: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Aerosol can of Microban and chemicals in unlocked closet. I suggest conducting a daily classroom check to ensure all hazardous products are locked. If the closet is missing the lock add it prior to the children entering the classroom. Item #853 Incident logs were not completed and maintained as required. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723. - Incident log was unable to be viewed. Staff member MM was not aware of where the incident log was stored. I suggest reviewing with routine substitutes the location of the incident log and how to log any incidents. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member KK hired 10/18/2023 medical report on file was older than twelve (12) months. The medical report on file was dated 1/30/2015. I suggest for new hires to the program that are coming from another position within the school system having the staff member provide you with a current medical report prior to employment. If the report is more than twelve (12) months old having the staff member complete an new medical report prior to their start of employment. Item #1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). -Shelter in place or lockdown drills were not practiced every three (3) months. The last documented lockdown was conducted on 8/29/2023. I suggest pre-planning the emergency drills to remind you when they are due. Item #1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. 10A NCAC 09 .2510 STAFF QUALIFICATIONS (j) Staff in part-time, full day, or track-out school-age care programs required to complete BSAC training shall do so within three months of becoming employed. - Staff member KK hired 10/18/2023 BSAC training was not completed within three (3) months of employment. Training was due to be completed by 1/18/2024 and the staff member completed the training on 1/21/2024. I suggest documenting on a calendar when new hired trainings are due and registering prior to the due date. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 3/12/2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The program’s year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - Permission to Administer medication form for chronic medical conditions must be updated every six (6) months. - I suggest storing items that have heating elements be stored up five (5) feet when not in use. When in use, staff member be close supervising the activity. - Initial training and documentation from when staff members are originally hired needed to be stored on site until one (1) year after the employee terminates employment. - Staff member MM hired 6/6/2014 on-going training hours are due by 6/6/2024. - Staff member MM hired 6/6/2014 criminal background check is due to be completed by 11/14/2024. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or (828) 200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1106 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2506 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: ATKINSON PSAM-PSPM-PLUS Facility ID: 45000241 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/25/2023 Number Present: 12 Completed Date: 9/25/2023 Age: From 5 To 10 Total Minutes: 160 Time In: 02:40 PM Time Out: 05:20 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 your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Beverly Myers, Substitute. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beverly Myers, Substitute, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Your program currently operates with a Five (5) Star Rated license effective 2/26/2020. The permit restrictions were in compliance including first shift, school-age only, meets enhanced space, meets reduced ratios, playground does not meet NC child care licensing safety requirements, meets reduced group size by one (1) from seven (7) point level. Beverly Myers, Substitute, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 3/8/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification BSAC Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions Upon arrival, I introduced myself to the Substitute. The group of children ages five to ten years old began arriving in the cafeteria at 2:55p. Once all of the children arrive, the group transitioned to wash hands at the restroom. While waiting in the hallway on the children to use the restroom and wash hands, one (1) child was stirring the mop solution in the mop bucket that was unattended in the hallway between the restrooms. The custodian’s cart was also observed unattended in the hallway between the restrooms with hazardous products unlocked. While waiting on the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located on the other hallway near the boy’s restroom at the water fountain. Once each of the children were accounted for, the group transitioned to the other hallway to allow the boys to use the restroom and wash their hands. After all of the children used the restroom and washed their hands, the group lined up to transition back to the cafeteria for snack. Once in the cafeteria, the group got their snack and sat at the table. After snack, the children transitioned to the tables for free play with legos, magnetic blocks. After free play, the group transitioned to use the restroom and go outside. Once outside, the group engaged in outdoor play with the climber, balls, swings, and gaga ball. The last fire drill was practiced on 9/22/2023. The last emergency drill, lockdown drill, was practiced on 8/29/2023. The last fire inspection was approved on 3/10/2023. The program’s most recent sanitation inspection was completed on 2/24/2023, with four (4) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, BSAC, Special Training including Health and Safety Training and Criminal Background Checks. There is one (1) new staff member since the last annual compliance visit. The staff and training worksheet was completed for the new staff member files that were monitored. The following violations of child care requirements were observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. .2820(b) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. .0701(a) 1054 Documentation of staff's on-going training was not on file and/or was not current . Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. 10A NCAC 09 .1106(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. 10A NCAC 09 .0514(f) 1424 School-aged children were not adequately supervised. While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. .2506(d)(1-3) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. .0701(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. Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. .1103(b) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/9/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination, electronic or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. - Unattended custodian cart and mop bucket was located in the hallway between the restrooms. The storage cabinet located on the right as you enter the mobile unit was unlocked and Clorox wipes were located on the bottom shelf. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. - Staff member BM hired 1/10/2000 personnel file did not contain an annual health questionnaire. The health questionnaire on file was dated 8/23/2022. Item #1054 Documentation of staff's on-going training was not on file and/or was not current. 10A NCAC 09 .1106 DOCUMENTATION OF ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) Each center shall have a record of training activities in which each staff member participates, including copies of training certificates or official documentation provided by the trainer. That record shall include the subject matter, topic area in G.S. 110-91(11), training provider, date provided, hours, and name of staff who completed the training. This documentation shall be on file and current. - Staff member BM hired 1/10/2000, on-going training documentation was not on-file for review. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. - Staff member BM hired 1/10/2000 personnel file did not contain an annual staff evaluation. The annual staff evaluation on file was dated 6/26/2017. Item #1424 School-age children were not adequately supervised. 10A NCAC 09 .2506 GENERAL SAFETY REQUIREMENTS (d) All children shall be adequately supervised. Adequate supervision means staff shall be with the group of children and able to hear or see each child in his or her care, except: (1) Children who are developmentally able may be permitted to go to the restroom independently, provided that: (A) staff members' proximity to children assures immediate intervention to safeguard a child from harm; (B) individuals who are not staff members may not enter the restroom area while in use by any child; and (C) children up to nine years of age are supervised by staff members who are able to hear the child. Children nine years of age and older are not required to be directly supervised, however, staff members shall know the whereabouts of children who have left their group to use the restroom; (2) Adequate supervision for children nine years of age and older means that staff are with the group of children and able to hear or see each child in his or her care. A staff member shall accompany any children who leave the group to go indoors or outdoors; and (3) When emergencies necessitate that direct supervision is impossible for brief periods of time. - While the children were waiting for the girls to finish using the restroom, it was observed that Ms. Myers was unaware of where one (1) child was located by repeatedly counting the children and checking the restroom. The child was located in the other hallway near the boy’s restroom at the water fountain. Item #1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening, and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (d) Staff medical statements, proof of a tuberculosis test or screening, and completed health questionnaires shall be included in the staff member's medical file, which must be maintained separately from the staff member's individual personnel file in the center. - Staff member BM hired 1/10/2000 personnel file did not contain proof of tuberculosis test or screen. Item #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. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. -Staff member BM hired 1/10/2000 health and safety training topics were not included as part of on-going training within five (5) years of completing the previous health and safety training topics. The previous certificates on file were dated 6/13/2017. Consultation: Today, we discussed the following: - We discussed that you are a part of Cohort 2 for rated license reassessments. The programs year of preparation will begin 7/1/2024 and end 6/30/2025. The assessment year will begin 7/1/2025 and end 6/30/2026. We discussed that each staff member will need to update their WORKS account to reflect their most recently completed education. Also, be sure to take advantage of the preparation year assessment. - A refresher course on active supervision needs to be offered and completed by staff member BM hired 1/10/2000. - Discuss with the school administrator on a plan for the custodian carts and mop buckets to be locked at all times when not in use. - Health and safety training topics are to be completed on or before five (5) years from the pervious completion certificate date. - Staff evaluation and health questionnaires are to be completed annually. - On-going training hours need to be on file for review. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times