Grace Lutheran Preschool

10A NCAC 09 .0803 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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

GS 110-106 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 94 Completed Date: 4/1/2026 Age: From 1 To 6 Total Minutes: 145 Time In: 09:50 AM Time Out: 12:15 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 compliance during an routine unannounced 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/16/2025. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight percent (88%) as of 3/30/2026. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Special Services/Restrictions – first shift daytime care. The last fire drill was practiced on 3/11/2026. The last lockdown drill was practiced on 1/23/2026. The last playground inspection was documented on 3/5/2026. The last fire inspection was approved on 1/21/2026. The last sanitation inspection was conducted on 1/15/2026 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in transitioning outdoors for Easter egg hunt. Staff were engaged in the activity with the children. While outside, an incident occurred with two (2) boys. One (1) child flipped out of a chair hitting their head on the concrete wall. Staff responded immediately getting an ice pack, notifying the administrator and parents, and completing the incident report. In space #127, the group of four- to six-year-olds half of the class was in the classroom with staff members engaged in group activity on the carpet and the other half of the class was in the library with the staff member. In space #126, the group of three-to- four-year-old children were engaged in group time. After group time the group transitioned outdoors for gross motor play. Staff were actively supervising the children. In space # 122, the group of three-to-four-year-old children were outside engaged in gross motor play. After gross motor play, the group transitioned indoors to prepare for snack. While monitoring indoors, I observed two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. While monitoring medications, I observed one epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. In space #111, the group of two-year-old children were engaged in outdoor gross motor play. Staff were actively supervising the children. While monitoring the classroom, I observed one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. In space #107, the group of one-year- old children were preparing to transition outdoors for gross motor play. One (1) staff member was assisting the children with getting in the bye bye buggy while the other staff member was in the classroom assisting the children with cleaning up. While monitoring the classroom, I observed plastic wipe packaging unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. In space #104, the group of two- to three-year-old children were engaged in snack at the table. Staff were stationed close to the tables to easily assist the children as needed. Dismissal began at 11:30a. Staff assisted the children with departing. When dismissal is concluded, the staff assist the remaining children with transitioning to the aftercare classrooms. Space 131, 126, and 111 are used for aftercare. Aftercare dismissal begins at 1:20p. Quality Rating and Improvement System (QRIS): We discussed the available QRIS modernization pathways. Ms. Lehr indicated that she does not wish to pursue a star-rated license at this time and will continue operating under the Notice of Compliance. 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. Space #122, two (2) aerosol cans in an unlocked cabinet. .2820(b) 847 Parent's medication authorization did not include required information. Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. 10A NCAC 09 .0803(4)(6-9) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children .0604(q) Technical assistance was provided as follows: Item 840- Space #122, two (2) aerosol cans in an unlocked cabinet. The administrator moved the aerosol cans to a locked cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 847- Space #122, one (1) epi pen permission to administer medication form not completed. The form was missing the beginning and end date, along with the date the parent signed the form. The form was corrected during the visit. Rule Reference: 10A NCAC 09 .0803(4)&(6-9) Item 858- Space #111, one (1) plastic water wipes package on the bathroom counter below five (5) feet accessible to the children. The administrator moved the wipe packaging up five (5) feet to be inaccessible to the children. Space #107, plastic wipe packagings unlocked under the diaper changer assessable to children. The staff stated they had just finished changing a diaper and forgot to lock it back. They corrected this during the visit by locking the cabinet. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We reviewed hazardous product storage (ex. Aerosol cans, plastic packaging, etc). We discussed the storage of equipment with heating elements in the art room/food prep area. Equipment should be stored according to the manufactures instructions. ABCMS- Continue to update the ABCMS portal as new staff are hired and current staff resign. 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. The Healthy Social Behaviors Project (HSB) helpline for managing challenging behaviors telephone number (1-888-600-1685 Option 1), online portal, and Talk to the Expert space in the Social-Emotional Connections is available. Healthy Social Behaviors Project (HSB) now have an email for requesting HSB Coaching or training: HSB@ChildCareResourcesInc.org. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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 .0601 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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 .0604 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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 .0604 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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 .2506 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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. 110-91 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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

GS 110-106 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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

GS 110-91 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/16/2025 Number Present: 78 Completed Date: 9/16/2025 Age: From 1 To 5 Total Minutes: 305 Time In: 09:25 AM Time Out: 02:30 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 Beth Ann Lehr, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me during the walkthrough until she had to leave for an appointment. Ami Service, Assistant Director, assisted me with the remainder of the visit. Ms. Lehr returned at 12:50p. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine percent (89%) as of 8/4/2025. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 5/22/2025. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 9/23/2024. The last fire drill was practiced on 8/7/2025. The last lockdown drill was practiced on 7/17/2025. The next drill is due in October. The last playground inspection was documented on 9/5/2025. The last fire inspection was approved on 1/29/2025. The last sanitation inspection was conducted on 3/6/2025 with zero (0) demerits for a superior classification. The last lead water test was completed on 4/24/2024. The next testing is due by 4/24/2027. The last lead paint and asbestos testing was completed on 6/4/2024. The next testing is due by 4/24/2027. The Emergency Medical Care plan was posted and current. The program does not provide transportation. In space #131, the group of four- to five-year-old children were engaged in free play with blocks, magnetic toys, and free art. Staff were actively engaged in play with the children while supervising. In space #127, the group of four- to five-year-olds were engaged in free play with tubes, blocks, math and coloring activity, and blocks. The staff were working with in small groups with the children and actively supervising the children. While monitoring the first aid kit, I observed alcohol pads in the kit. The administrator removed the alcohol pads during the visit. In space #126, the group of three-year-old children were finishing group time and lining up to transition outdoors for gross motor. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space # 122, the group of three-year-old children were lining up and transitioning outdoors for gross motor play. The staff were stationed at the front and end of the line to supervise the children as they transitioned outdoors. In space #111, the group of one-to -two-year-old children were engaged in eating snack at the tables. One (1) staff member was stationed at each table supervising the children. In space #107, the group of one-year- old children were engaged in free play with bells, baby dolls. Staff were moving about the indoor area supervising the children. While monitoring indoors, I observed one (1) electrical outlet uncovered. This was corrected during the visit. In space #104, the group of two- to three-year-old children were engaged in free play with cars, blocks, puzzles. The staff were moving about the indoors and supervising the children. While monitoring the indoors environment, I observed one (1) aerosol can of Febreeze unlocked on the shelf beside the sink. The staff members moved the can of Febreeze to a locking cabinet during the visit. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Staff and children’s files were monitored. The outdoor environment was monitored, and the following items were observed, on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed replacing the three (3) wooden boards to prevent a child from being injured. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. 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 807 A safe indoor and outdoor environment was not provided for the children. Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #107 one (1) electrical outlet was uncovered and accessible to the children. 10A NCAC 09 .0604(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. GS 110-91(6); .0605((i) 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. One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. In space # 126, alcohol pads were observed in the first aid kit. .2820(b) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. .2506(c) Technical assistance was provided as follows: Item 807- Outside on the preschool playground a water hose ran across the walkway to the walker playground creating a potential trip hazard. Walker playground, three wooden privacy fence boards were deteriorating and creating sharp edges that could splinter and injure a child. We discussed to running the water hose along the building and when it crosses the walkway to place an outdoor foam mat or cover it with mulch to prevent any trip hazards. Also, we discussed to replace the three (3) wooden boards to prevent a child from being injured. Rule Reference: 10A NCAC 09 .0601(a) Item 812- In space #107 one (1) electrical outlet was uncovered and accessible to the children. The electrical outlet was covered during the visit. Rule Reference: 10A NCAC 09 .0604(c) Item 824- The fence at the entrance to the preschool playground measured three (3) foot nine (9) inches on both sides of the gate. We discussed that the buildup of leaves and mulch would need to be pulled away from the base of the fence to achieve a four (4) feet fence height. Rule Reference: G.S. 110-91(6);.0605(i) Item 840- One (1) aerosol can of Febreze was observed unlocked on the shelf beside the handwashing sink in space #104. The teacher moved this to a locked cabinet during the visit. In space # 126, alcohol pads were observed in the first aid kit. The administrator removed these during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 1422- Storage building was unlocked with bungie cord wrapped about the handle. Propane grill and three (3) propane tanks were stored in the storage building. We discussed that the propane grill and tanks must be locked at all times or removed from the premises. Rule Reference: 10A NCAC 09 .2506(c) 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 9/30/2025. 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 -Conducting daily indoor and outdoor environment checks to ensure all items are in compliance and hazardous products are stored appropriately. Outdoors if items are hazardous to report those to the administrator immediately. -Conducting a monthly check of the first aid kit to ensure the appropriate items are in the first aid kit and any hazardous items are stored appropriately. -When entering the hours worked on the staff and training worksheet to ensure you enter the actual times each staff member works and the days they work. When entering dates be sure to include the month, day, and year to verify items were completed. 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.” 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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 .0604 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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

GS 110-106 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 3/27/2025 Number Present: 87 Completed Date: 3/27/2025 Age: From 1 To 5 Total Minutes: 140 Time In: 09:40 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced 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 Beth Ann Lehr, Administrator during the visit. A signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 9/23/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification 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 facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/15/2024. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Special Services/Restrictions – First shift. The last fire drill was practiced on 3/10/2025. The last emergency drill, lockdown drill, was practiced on 1/23/2025. The last fire inspection was approved on 1/29/25. The program’s most recent sanitation inspection was completed on 3/6/2025, with zero (0) demerits. The Emergency Medical Care Plan is posted and current. In space #131, the group of four- to five-year-old children were engaged in group time on the carpet with the teacher. In space #127, the group of four- to five-year-olds were engaged in free play with magnetic tiles, free art, blocks, and working one on one with staff. In space #126, the group of three-year-old children were eating snack at the tables. One (1) staff was supervising the children at the tables and the other staff member was assisting a child in the restroom. In space # 122, the group of three-and four-year-old children were eating snack at the tables. Space #135 and 136, two (2) groups of two-and three-year-olds were engaged in indoor gross motor play due to the air quality code purple was issued due to the wildfires. The children engaged in gross motor play with hula hoops, climbers, tunnels, steppers, and the pretend kitchen. Four (4) staff members were spaced to actively supervise the twenty-two (22) children engaged in gross motor play. In space #111, the group of one-to -two-year-old children were engaged in indoor gross motor play in the gross motor room. After gross motor play, the group transitioned back to the classroom to wash hands and prepare for snack. In space #107, the group of one-and two-year-old children were engaged in free play, finishing up snack, and routine diaper changes. One (1) staff member was conducting routine diaper changes and the other staff member was supervising the children and assisting the children. The classroom also had an observer, Shannon Kiggens from Child and Family Resource Center. During the visit, Ms. Kiggens assisted the staff with reading to the children in the cozy area. While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. The locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. In space #104, the group of two- and three-year-old children were engaged in indoor gross motor play. After gross motor play, the group transitioned back to the room to wash hands and prepare for snack. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provided meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Criminal Background Checks. 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. Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. .0604(q) Technical assistance was provided as follows: Item 840 Space #107, one (1) locking cabinet that stored Clorox wipes and Benadryl was not locked. We discussed the cabinet was not locking. The administrator fixed the magnetic latch to lock the cabinet during the visit. Rule Reference: 15A NCAC 18A.2820(b) Item 858 Space #107, While monitoring the classroom, I observed the closed behind the diaper changer unlocked with plastics stored below five (5) feet accessible to children under three years old. The administrator corrected this during the visit by ensuring that the double doors were locked and secured appropriately. She also reminded the staff to ensure that the doors are locked and closed appropriately. Rule Reference: 10A NCAC 09 .0604(q) Consultation is provided as follows: We discussed to watch the air quality for outdoor gross motor play using the www.airnow.gov website. Please keep me updated on any changes with the facility operations due to the wildfires. Due to Tropical Storm Helene guidance was provided to allow more time to achieve compliance on 10/28/2024: * Staff member AS First Aid and CPR certification was due to be recertified by 11/5/2024. The staff member received the online portion of the training on 10/24/2024. The second part of the class, the in-person skills part of the course on 10/29/2024 was canceled on 10/25/2024 due to Tropical Storm Helene. The facility attempted to call the Red Cross of Asheville, and all classes were canceled till January 2025 due to Tropical Storm Helene. The earliest skills class the staff member could attend was on 11/15/2024 at 9:00a in Hendersonville. The staff member attended and completed the in-person skills course on 11/15/2024. The staff members' current certification is on file for review. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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 .0601 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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 .1005 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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 .1401 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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 .1402 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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

GS 110-106 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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

GS 110-91 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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

GS110-91 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 9/23/2024 Number Present: 90 Completed Date: 9/23/2024 Age: From 1 To 4 Total Minutes: 215 Time In: 09:55 AM Time Out: 01:30 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 Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Beth Ann Lehr, Administrator 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 ninety-two percent (92%) as of 9/19/2024. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/4/2023. The last fire drill was practiced on 8/13/2024. The last lockdown drill was practiced on 7/18/2024. The last playground inspection was documented on 9/18/2024. The last fire inspection was approved on 2/8/2024. The last sanitation inspection was conducted on 2/6/2024 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was updated on 7/24/2024. In space #131, the group of four- to five-year-old children were engaged in group time. The staff was reading a story to the group. In space #127, the group of four- to five-year-olds were engaged in free play with free art, blocks, writing, cars, and dramatic play. The staff was working one on one with the children while actively supervising the children. In space #126, the group of three-year-old children were transitioning outdoors for gross motor play. Once outdoors, the children engaged in gross motor play with the trikes, climbers, and slides. In space # 122, the group of three-year-old children were transitioning outside for gross motor play. While monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. In space #111, the group of one-to -two-year-old children were engaged in snack time at the table. The staff were sitting with the children. One (1) child was observed in a highchair eating snack. We discussed the need to have the manufactures instructions on file to show that the high chair is age appropriate for the child to use. While reviewing the highchair manufactures instructions, the high chair is developmentally age appropriate to be used for children six (6) months and up to fifty (50) pounds. In space #107, the group of one-year- old children were engaged in snack at the tables. The staff were assisting the children as needed and conducting routine diaper changes. In space #104, the group of two- to three-year-old children were engaged in group time singing happy birthday to the child who turned three today. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. Nutritional Opt out form was on file for each child enrolled and parents provide meals and snacks from home. 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 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. In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. .2820(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022 GS110-91(1) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. .0608(b)(1-6) Technical assistance was provided as follows: Item # 840 In space #122 while monitoring the indoor space, I observed one (1) can of Satin Care shaving cream unlocked in the left cabinet on the wall behind the door. The administrator discarded the shaving cream during the visit. We discussed conducting a daily classroom check to ensure all hazardous products are stored appropriately. Rule Reference: 15A NCAC 18A.2820(b) Item #1321 Child enrolled 3/25/2021 medical record on file was not on file before enrollment or within thirty (30) days after admission. The medical record on file was dated 9/26/2022. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: GS 110-91 (1) Item #1908 Child enrolled 9/3/2024 a signed and dated statement by parent that the Prevention of Shaken Baby and Abusive Head Trauma policy was not on file to document that the policy was received and explained at enrollment. We discussed to use the children’s file checklist to assist with ensuring each document is on file within the appropriate timeframe. Rule Reference: 0608. (c) 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 10/7/2024. 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: - We reviewed and discussed the requirements for field trips, off-premises activities, and outside the fenced in area permission. 10A NCAC 09 .1005 OFF PREMISE ACTIVITIES IN CHILD CARE CENTERS (a) Off premise activities refer to any activity that takes place away from a child care center's licensed and approved space. Licensed and approved space includes "primary space" as described in 10A NCAC 09 .1401(a), outdoor space as described in 10A NCAC 09 .1402, single use rooms, or other administrative areas. (b) When children participate in off premise activities the following shall apply: (1) Children under the age of three shall not participate in off premise activities that involve children being transported in a motor vehicle. (2) When children are transported in a motor vehicle for off premise activities, the provisions in Rule .1003(c) through (i) and (k) of this Chapter shall apply. (3) Before staff members walk children off premises for play or outings, the center shall obtain written permission from the parent of each child to be included in such activities. (4) Parents may provide a written statement giving standing permission which may be valid for up to 12 months for participation in off premise activities that occur on a regular basis. (5) The center shall post a schedule of off premise activities in each participating classroom where it can be viewed by parents, and a copy shall be given to parents. The schedule shall be current and shall include the: (A) location of the activity; (B) purpose of the activity; (C) time the activity will take place; (D) date of the activity; and (E) name of the person(s) to be contacted in the event of an emergency. (6) Each time that children are taken off the premises, staff shall take a list of the children participating in the activity with them. Staff members shall use this list to check attendance when leaving the center, periodically when the children are involved in the activity, before leaving the activity to return to the child care center, and upon return to the center. A list of all children participating in the off premise activity shall also be available at the center. (c) The provisions of Subparagraphs (b)(1) and (5) of this Rule shall be waived to implement any child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). -We reviewed and discussed the requirements for manufacturer’s instructions. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) All child care centers shall provide a safe indoor and outdoor environment for the children in care. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) Staff of the center shall immediately remove all equipment and furnishings that do not meet the requirements of Paragraphs (b) and (c) of this Rule from the premises or make the equipment or furnishings inaccessible to the children. (e) Each child care center shall provide equipment and furnishings that are child-size or that can be adapted for use by children. Chairs and tables shall be of appropriate height for the children who will be using them. (f) Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/19/2024 Number Present: 89 Completed Date: 4/19/2024 Age: From 1 To 5 Total Minutes: 235 Time In: 09:20 AM Time Out: 01:15 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, Beth Ann Lehr, Administrator. 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 Beth Ann Lehr, Administrator, during the visit. The visit summary was signed and left on-site with you. Your program currently operates with a Notice of Compliance GS 110-106 effective 12/7/2016. The permit restrictions were in compliance including first shift (daytime care). Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 10/4/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS 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 A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. Ms. Lehr was available to assist. Space #131, the group of four- to five-year-old children were engaged in a special recycling activity with a guest speaker. After the special activity, the group transitioned to free play. Then outdoors for gross motor play. Space #127, the group of four- to five-year-old children were engaged in free play with blocks, puzzles, and art. After free play, the group transitioned to a special recycling activity located in the auxiliary space. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. One (1) prescription medication did not have the pharmacy label. Space #126, the group of three- to four-year-old children were engaged in free play with art, and blocks. After free play, the children transitioned outdoors for gross motor play. Space #122, the group of three- to four-year-old children were engaged in free play with sand, art, and books. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. Space #111, the group of two-year-old children were outside engaged in indoor gross motor in the gross motor room # 135 and 136. Space #107, the group of one to two year old children were cleaning up and transitioning to group music and movement activity with the teacher. While checking medications in this space, one (1) Aquaphor diaper cream expired 3/2024. Space #104, the group of two- to three-year-old children were engaged in indoor gross motor play in the gross motor room #135 and #136. After gross motor play, the group transitioned to the classroom and washed hands. All children have a Nutritional Opt Out form on file and bring all meals and snacks from home. The center does not accept subsidy or provide transportation. The last fire drill was practiced on 4/18/2024. The last emergency drill, shelter in place drill, was practiced on 4/10/2024. The last fire inspection was approved on 3/1/2023. The administrator stated that the inspection was completed, but does not have a copy on file for review. She reached out to the Executive Director of Operations and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. The program’s most recent sanitation inspection was completed on 9/20/2023, with two (2) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. There are three (3) new staff member since the last annual compliance visit. The completed staff and training worksheet was received during the visit. The gross motor, library, and art room were measured during the visit. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. 10A NCAC 09 .0304(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. 10A NCAC 09 .0803(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. In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. .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. In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. .0803(12) 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 5/3/2024. 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 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 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 #106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) 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. - Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. I suggest contacting the Fire Marshal one to two months prior to your inspection due date to ensure that they have you on the schedule. Then ensure that you stress the importance of your inspection being conducted prior to the previous completion date. Also, add a reminder on your calendar to mail the completed inspection to me within one (1) week of completion. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; -In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. I suggest reviewing all medications to ensure that a permission to administer medication form completed along with the any medical action plans prior to taking the medication to the classroom. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. I suggest reviewing the medication to ensure it is in the original container and has the original pharmacy label on the medication to ensure it is for the specified child. Item #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. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. I suggest conducting a monthly medication check to review the permission to administer medication forms, medical action plans, and the medication to ensure the forms and medication has not expired. Consultation: Today, we discussed the following: - Review how to complete the permission to administer medication form with the parents and staff. Ensuring that a specific measurable dosage is listed in the amount/dosage space, and the specific administration dates are listed for the appropriate timeline that does not exceed twelve (12) months. - Plastic bags and wipe packaging’s in spaces where children under three years of age is cared for must be stored up five (5) feet due to potential choking and suffocation hazards. 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. 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 .0803 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/19/2024 Number Present: 89 Completed Date: 4/19/2024 Age: From 1 To 5 Total Minutes: 235 Time In: 09:20 AM Time Out: 01:15 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, Beth Ann Lehr, Administrator. 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 Beth Ann Lehr, Administrator, during the visit. The visit summary was signed and left on-site with you. Your program currently operates with a Notice of Compliance GS 110-106 effective 12/7/2016. The permit restrictions were in compliance including first shift (daytime care). Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 10/4/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS 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 A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. Ms. Lehr was available to assist. Space #131, the group of four- to five-year-old children were engaged in a special recycling activity with a guest speaker. After the special activity, the group transitioned to free play. Then outdoors for gross motor play. Space #127, the group of four- to five-year-old children were engaged in free play with blocks, puzzles, and art. After free play, the group transitioned to a special recycling activity located in the auxiliary space. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. One (1) prescription medication did not have the pharmacy label. Space #126, the group of three- to four-year-old children were engaged in free play with art, and blocks. After free play, the children transitioned outdoors for gross motor play. Space #122, the group of three- to four-year-old children were engaged in free play with sand, art, and books. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. Space #111, the group of two-year-old children were outside engaged in indoor gross motor in the gross motor room # 135 and 136. Space #107, the group of one to two year old children were cleaning up and transitioning to group music and movement activity with the teacher. While checking medications in this space, one (1) Aquaphor diaper cream expired 3/2024. Space #104, the group of two- to three-year-old children were engaged in indoor gross motor play in the gross motor room #135 and #136. After gross motor play, the group transitioned to the classroom and washed hands. All children have a Nutritional Opt Out form on file and bring all meals and snacks from home. The center does not accept subsidy or provide transportation. The last fire drill was practiced on 4/18/2024. The last emergency drill, shelter in place drill, was practiced on 4/10/2024. The last fire inspection was approved on 3/1/2023. The administrator stated that the inspection was completed, but does not have a copy on file for review. She reached out to the Executive Director of Operations and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. The program’s most recent sanitation inspection was completed on 9/20/2023, with two (2) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. There are three (3) new staff member since the last annual compliance visit. The completed staff and training worksheet was received during the visit. The gross motor, library, and art room were measured during the visit. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. 10A NCAC 09 .0304(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. 10A NCAC 09 .0803(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. In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. .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. In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. .0803(12) 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 5/3/2024. 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 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 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 #106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) 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. - Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. I suggest contacting the Fire Marshal one to two months prior to your inspection due date to ensure that they have you on the schedule. Then ensure that you stress the importance of your inspection being conducted prior to the previous completion date. Also, add a reminder on your calendar to mail the completed inspection to me within one (1) week of completion. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; -In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. I suggest reviewing all medications to ensure that a permission to administer medication form completed along with the any medical action plans prior to taking the medication to the classroom. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. I suggest reviewing the medication to ensure it is in the original container and has the original pharmacy label on the medication to ensure it is for the specified child. Item #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. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. I suggest conducting a monthly medication check to review the permission to administer medication forms, medical action plans, and the medication to ensure the forms and medication has not expired. Consultation: Today, we discussed the following: - Review how to complete the permission to administer medication form with the parents and staff. Ensuring that a specific measurable dosage is listed in the amount/dosage space, and the specific administration dates are listed for the appropriate timeline that does not exceed twelve (12) months. - Plastic bags and wipe packaging’s in spaces where children under three years of age is cared for must be stored up five (5) feet due to potential choking and suffocation hazards. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/19/2024 Number Present: 89 Completed Date: 4/19/2024 Age: From 1 To 5 Total Minutes: 235 Time In: 09:20 AM Time Out: 01:15 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, Beth Ann Lehr, Administrator. 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 Beth Ann Lehr, Administrator, during the visit. The visit summary was signed and left on-site with you. Your program currently operates with a Notice of Compliance GS 110-106 effective 12/7/2016. The permit restrictions were in compliance including first shift (daytime care). Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 10/4/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS 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 A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. Ms. Lehr was available to assist. Space #131, the group of four- to five-year-old children were engaged in a special recycling activity with a guest speaker. After the special activity, the group transitioned to free play. Then outdoors for gross motor play. Space #127, the group of four- to five-year-old children were engaged in free play with blocks, puzzles, and art. After free play, the group transitioned to a special recycling activity located in the auxiliary space. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. One (1) prescription medication did not have the pharmacy label. Space #126, the group of three- to four-year-old children were engaged in free play with art, and blocks. After free play, the children transitioned outdoors for gross motor play. Space #122, the group of three- to four-year-old children were engaged in free play with sand, art, and books. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. Space #111, the group of two-year-old children were outside engaged in indoor gross motor in the gross motor room # 135 and 136. Space #107, the group of one to two year old children were cleaning up and transitioning to group music and movement activity with the teacher. While checking medications in this space, one (1) Aquaphor diaper cream expired 3/2024. Space #104, the group of two- to three-year-old children were engaged in indoor gross motor play in the gross motor room #135 and #136. After gross motor play, the group transitioned to the classroom and washed hands. All children have a Nutritional Opt Out form on file and bring all meals and snacks from home. The center does not accept subsidy or provide transportation. The last fire drill was practiced on 4/18/2024. The last emergency drill, shelter in place drill, was practiced on 4/10/2024. The last fire inspection was approved on 3/1/2023. The administrator stated that the inspection was completed, but does not have a copy on file for review. She reached out to the Executive Director of Operations and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. The program’s most recent sanitation inspection was completed on 9/20/2023, with two (2) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. There are three (3) new staff member since the last annual compliance visit. The completed staff and training worksheet was received during the visit. The gross motor, library, and art room were measured during the visit. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. 10A NCAC 09 .0304(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. 10A NCAC 09 .0803(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. In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. .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. In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. .0803(12) 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 5/3/2024. 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 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 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 #106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) 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. - Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. I suggest contacting the Fire Marshal one to two months prior to your inspection due date to ensure that they have you on the schedule. Then ensure that you stress the importance of your inspection being conducted prior to the previous completion date. Also, add a reminder on your calendar to mail the completed inspection to me within one (1) week of completion. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; -In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. I suggest reviewing all medications to ensure that a permission to administer medication form completed along with the any medical action plans prior to taking the medication to the classroom. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. I suggest reviewing the medication to ensure it is in the original container and has the original pharmacy label on the medication to ensure it is for the specified child. Item #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. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. I suggest conducting a monthly medication check to review the permission to administer medication forms, medical action plans, and the medication to ensure the forms and medication has not expired. Consultation: Today, we discussed the following: - Review how to complete the permission to administer medication form with the parents and staff. Ensuring that a specific measurable dosage is listed in the amount/dosage space, and the specific administration dates are listed for the appropriate timeline that does not exceed twelve (12) months. - Plastic bags and wipe packaging’s in spaces where children under three years of age is cared for must be stored up five (5) feet due to potential choking and suffocation hazards. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/19/2024 Number Present: 89 Completed Date: 4/19/2024 Age: From 1 To 5 Total Minutes: 235 Time In: 09:20 AM Time Out: 01:15 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, Beth Ann Lehr, Administrator. 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 Beth Ann Lehr, Administrator, during the visit. The visit summary was signed and left on-site with you. Your program currently operates with a Notice of Compliance GS 110-106 effective 12/7/2016. The permit restrictions were in compliance including first shift (daytime care). Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 10/4/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS 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 A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. Ms. Lehr was available to assist. Space #131, the group of four- to five-year-old children were engaged in a special recycling activity with a guest speaker. After the special activity, the group transitioned to free play. Then outdoors for gross motor play. Space #127, the group of four- to five-year-old children were engaged in free play with blocks, puzzles, and art. After free play, the group transitioned to a special recycling activity located in the auxiliary space. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. One (1) prescription medication did not have the pharmacy label. Space #126, the group of three- to four-year-old children were engaged in free play with art, and blocks. After free play, the children transitioned outdoors for gross motor play. Space #122, the group of three- to four-year-old children were engaged in free play with sand, art, and books. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. Space #111, the group of two-year-old children were outside engaged in indoor gross motor in the gross motor room # 135 and 136. Space #107, the group of one to two year old children were cleaning up and transitioning to group music and movement activity with the teacher. While checking medications in this space, one (1) Aquaphor diaper cream expired 3/2024. Space #104, the group of two- to three-year-old children were engaged in indoor gross motor play in the gross motor room #135 and #136. After gross motor play, the group transitioned to the classroom and washed hands. All children have a Nutritional Opt Out form on file and bring all meals and snacks from home. The center does not accept subsidy or provide transportation. The last fire drill was practiced on 4/18/2024. The last emergency drill, shelter in place drill, was practiced on 4/10/2024. The last fire inspection was approved on 3/1/2023. The administrator stated that the inspection was completed, but does not have a copy on file for review. She reached out to the Executive Director of Operations and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. The program’s most recent sanitation inspection was completed on 9/20/2023, with two (2) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. There are three (3) new staff member since the last annual compliance visit. The completed staff and training worksheet was received during the visit. The gross motor, library, and art room were measured during the visit. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. 10A NCAC 09 .0304(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. 10A NCAC 09 .0803(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. In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. .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. In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. .0803(12) 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 5/3/2024. 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 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 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 #106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) 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. - Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. I suggest contacting the Fire Marshal one to two months prior to your inspection due date to ensure that they have you on the schedule. Then ensure that you stress the importance of your inspection being conducted prior to the previous completion date. Also, add a reminder on your calendar to mail the completed inspection to me within one (1) week of completion. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; -In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. I suggest reviewing all medications to ensure that a permission to administer medication form completed along with the any medical action plans prior to taking the medication to the classroom. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. I suggest reviewing the medication to ensure it is in the original container and has the original pharmacy label on the medication to ensure it is for the specified child. Item #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. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. I suggest conducting a monthly medication check to review the permission to administer medication forms, medical action plans, and the medication to ensure the forms and medication has not expired. Consultation: Today, we discussed the following: - Review how to complete the permission to administer medication form with the parents and staff. Ensuring that a specific measurable dosage is listed in the amount/dosage space, and the specific administration dates are listed for the appropriate timeline that does not exceed twelve (12) months. - Plastic bags and wipe packaging’s in spaces where children under three years of age is cared for must be stored up five (5) feet due to potential choking and suffocation hazards. 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. 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/19/2024 Number Present: 89 Completed Date: 4/19/2024 Age: From 1 To 5 Total Minutes: 235 Time In: 09:20 AM Time Out: 01:15 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, Beth Ann Lehr, Administrator. 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 Beth Ann Lehr, Administrator, during the visit. The visit summary was signed and left on-site with you. Your program currently operates with a Notice of Compliance GS 110-106 effective 12/7/2016. The permit restrictions were in compliance including first shift (daytime care). Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 10/4/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS 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 A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. Ms. Lehr was available to assist. Space #131, the group of four- to five-year-old children were engaged in a special recycling activity with a guest speaker. After the special activity, the group transitioned to free play. Then outdoors for gross motor play. Space #127, the group of four- to five-year-old children were engaged in free play with blocks, puzzles, and art. After free play, the group transitioned to a special recycling activity located in the auxiliary space. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. One (1) prescription medication did not have the pharmacy label. Space #126, the group of three- to four-year-old children were engaged in free play with art, and blocks. After free play, the children transitioned outdoors for gross motor play. Space #122, the group of three- to four-year-old children were engaged in free play with sand, art, and books. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. Space #111, the group of two-year-old children were outside engaged in indoor gross motor in the gross motor room # 135 and 136. Space #107, the group of one to two year old children were cleaning up and transitioning to group music and movement activity with the teacher. While checking medications in this space, one (1) Aquaphor diaper cream expired 3/2024. Space #104, the group of two- to three-year-old children were engaged in indoor gross motor play in the gross motor room #135 and #136. After gross motor play, the group transitioned to the classroom and washed hands. All children have a Nutritional Opt Out form on file and bring all meals and snacks from home. The center does not accept subsidy or provide transportation. The last fire drill was practiced on 4/18/2024. The last emergency drill, shelter in place drill, was practiced on 4/10/2024. The last fire inspection was approved on 3/1/2023. The administrator stated that the inspection was completed, but does not have a copy on file for review. She reached out to the Executive Director of Operations and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. The program’s most recent sanitation inspection was completed on 9/20/2023, with two (2) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. There are three (3) new staff member since the last annual compliance visit. The completed staff and training worksheet was received during the visit. The gross motor, library, and art room were measured during the visit. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. 10A NCAC 09 .0304(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. 10A NCAC 09 .0803(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. In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. .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. In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. .0803(12) 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 5/3/2024. 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 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 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 #106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) 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. - Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. I suggest contacting the Fire Marshal one to two months prior to your inspection due date to ensure that they have you on the schedule. Then ensure that you stress the importance of your inspection being conducted prior to the previous completion date. Also, add a reminder on your calendar to mail the completed inspection to me within one (1) week of completion. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; -In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. I suggest reviewing all medications to ensure that a permission to administer medication form completed along with the any medical action plans prior to taking the medication to the classroom. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. I suggest reviewing the medication to ensure it is in the original container and has the original pharmacy label on the medication to ensure it is for the specified child. Item #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. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. I suggest conducting a monthly medication check to review the permission to administer medication forms, medical action plans, and the medication to ensure the forms and medication has not expired. Consultation: Today, we discussed the following: - Review how to complete the permission to administer medication form with the parents and staff. Ensuring that a specific measurable dosage is listed in the amount/dosage space, and the specific administration dates are listed for the appropriate timeline that does not exceed twelve (12) months. - Plastic bags and wipe packaging’s in spaces where children under three years of age is cared for must be stored up five (5) feet due to potential choking and suffocation hazards. 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. 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

GS 110-106 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/19/2024 Number Present: 89 Completed Date: 4/19/2024 Age: From 1 To 5 Total Minutes: 235 Time In: 09:20 AM Time Out: 01:15 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, Beth Ann Lehr, Administrator. 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 Beth Ann Lehr, Administrator, during the visit. The visit summary was signed and left on-site with you. Your program currently operates with a Notice of Compliance GS 110-106 effective 12/7/2016. The permit restrictions were in compliance including first shift (daytime care). Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Beth Ann Lehr, Administrator, accompanied me today during the walk through and was available to assist with questions. The program’s annual compliance visit was conducted on 10/4/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS 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 A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. Ms. Lehr was available to assist. Space #131, the group of four- to five-year-old children were engaged in a special recycling activity with a guest speaker. After the special activity, the group transitioned to free play. Then outdoors for gross motor play. Space #127, the group of four- to five-year-old children were engaged in free play with blocks, puzzles, and art. After free play, the group transitioned to a special recycling activity located in the auxiliary space. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. One (1) prescription medication did not have the pharmacy label. Space #126, the group of three- to four-year-old children were engaged in free play with art, and blocks. After free play, the children transitioned outdoors for gross motor play. Space #122, the group of three- to four-year-old children were engaged in free play with sand, art, and books. While checking medications in this space, one (1) inhaler was monitored and did not have a permission to administer medication form completed and on-site. Space #111, the group of two-year-old children were outside engaged in indoor gross motor in the gross motor room # 135 and 136. Space #107, the group of one to two year old children were cleaning up and transitioning to group music and movement activity with the teacher. While checking medications in this space, one (1) Aquaphor diaper cream expired 3/2024. Space #104, the group of two- to three-year-old children were engaged in indoor gross motor play in the gross motor room #135 and #136. After gross motor play, the group transitioned to the classroom and washed hands. All children have a Nutritional Opt Out form on file and bring all meals and snacks from home. The center does not accept subsidy or provide transportation. The last fire drill was practiced on 4/18/2024. The last emergency drill, shelter in place drill, was practiced on 4/10/2024. The last fire inspection was approved on 3/1/2023. The administrator stated that the inspection was completed, but does not have a copy on file for review. She reached out to the Executive Director of Operations and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. The program’s most recent sanitation inspection was completed on 9/20/2023, with two (2) demerits. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. There are three (3) new staff member since the last annual compliance visit. The completed staff and training worksheet was received during the visit. The gross motor, library, and art room were measured during the visit. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. 10A NCAC 09 .0304(a) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. 10A NCAC 09 .0803(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. In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. .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. In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. .0803(12) 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 5/3/2024. 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 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 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 #106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) 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. - Facility did not have a current completed fire inspection on site for review. The inspection on file for review was dated 3/1/2023. The administrator stated that the inspection was completed but does not have a copy on file for review. She reached out to the Executive Director of Operations, and he stated that the inspection was completed on 2/8/2024 but the inspection form was not completed. The administrator is reaching out to the Fire Marshal to have the form completed. I suggest contacting the Fire Marshal one to two months prior to your inspection due date to ensure that they have you on the schedule. Then ensure that you stress the importance of your inspection being conducted prior to the previous completion date. Also, add a reminder on your calendar to mail the completed inspection to me within one (1) week of completion. Item #842 A drug or medicine was administered without written authorization and/or instructions from a child's parent or authorized health professional. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (b) without written instructions from the child's parent, physician or other health professional; -In space # 127 and #122 one (1) asthma inhaler was observed in both spaces on-site without written authorization from the child’s parent. I suggest reviewing all medications to ensure that a permission to administer medication form completed along with the any medical action plans prior to taking the medication to the classroom. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space # 127 one (1) Epi Pen was monitored without the original pharmacy labeled on the container. The administrator returned the medication to the parent to get a new prescription during the visit. I suggest reviewing the medication to ensure it is in the original container and has the original pharmacy label on the medication to ensure it is for the specified child. Item #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. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space #107 one (1) Aquaphor diaper cream was observed on-site that expired 3/2024. The administrator removed the expired diaper cream from the space during the visit and returned it to the parent during pickup. I suggest conducting a monthly medication check to review the permission to administer medication forms, medical action plans, and the medication to ensure the forms and medication has not expired. Consultation: Today, we discussed the following: - Review how to complete the permission to administer medication form with the parents and staff. Ensuring that a specific measurable dosage is listed in the amount/dosage space, and the specific administration dates are listed for the appropriate timeline that does not exceed twelve (12) months. - Plastic bags and wipe packaging’s in spaces where children under three years of age is cared for must be stored up five (5) feet due to potential choking and suffocation hazards. 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. 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 .0604 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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

GS 110-106 · Violation

Name of Operation: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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: GRACE LUTHERAN PRESCHOOL Facility ID: 45000362 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/4/2023 Number Present: 86 Completed Date: 10/4/2023 Age: From 1 To 5 Total Minutes: 240 Time In: 09:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Beth Ann Lehr, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Ami Service, Assistant Director, and Beth Ann Lehr, Administrator, were on-site and available to assist 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-eight percentage (88%) as of 9/28/2023. Grace Lutheran Church d/b/a Grace Lutheran Preschool does not have a Secretary of State listing due to being a non-profit, unincorporated organization. Permit type – Notice of Compliance, GS 110-106, issued 12/7/2016. Restrictions – First (1st) shift daytime care. The last annual compliance visit was conducted on 10/11/2022. The last fire drill was practiced on 9/17/2023. The last shelter-in-place drill was practiced on 7/27/2023. The last playground inspection was documented on 9/14/2023. The last fire inspection was approved on 3/1/2023. The last sanitation inspection was conducted on 9/20/2023 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is current and updated on 8/8/2023. The program does not provide transportation. This facility does not accept subsidy. Upon arrival, I introduced myself to the Assistant Director. In space #131, the group of four- to five-year-old children were engaged in group story time. The staff member was reading the book Being Mean and asking the questions related to the story and talking to the children about how it is not nice to be mean to our friends. In space #127, the group of four- to five-year-olds were engaged in group time reviewing the calendar and days of the week. In space #126, the group of three-year-old children were cleaning up and preparing to transition outside for gross motor play. In space # 122, the group of three- to four-year-old children were engaged in outdoor gross motor play. In space #111, the group of two-to -three-year-old children were transitioning back into the classroom from the restroom and having water at the table. In space #107, the group of one- to- year- old children were looking at books, sitting at the table, exploring the room, and having routine diaper changes conducted. In space #104, the group of one- to two-year-old children were transitioning indoors from gross motor play. All staff interactions were positive and nurturing. The staff were actively engaged and supervising the children. All medications were monitored. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. The facility has a total of twenty-seven (27) staff members. Today, I monitored seven (8) new staff files and three (3) existing staff files. There are one hundred twenty-one (121) children enrolled. Twelve (12) children’s files were monitored 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 815 Electrical cords were accessible to infants and toddlers. In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 10A NCAC 09 .0604(f) 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. In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. .0604(q) 1314 Emergency information did not name childs health care professional. Child JH emergency information did not contain the child’s health care professional name and number. .0802(c)(2) Technical assistance was provided as follows: Item #815 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (f) Electrical cords shall not be accessible to infants and toddlers. Extension cords, except as approved by the local fire inspector, shall not be used. Frayed or cracked electrical cords shall be replaced. - In space #126, an active extension cord with an uncovered outlet was located laying on the cabinet. The administrator added a safety outlet cover to the empty plug. 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. - In space # 111, Lysol disinfectant wipes with multiple warnings was located on a shelf above the hand washing sink. The assistant director moved this to a locking cabinet during the visit. Item #858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. - In space #111, plastic wipe packaging was located below five (5) feet and accessible to children under three years of age. The staff corrected this during the visit. Item #1314 Emergency information did not name child’s health care professional. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (2) the responsible party's choice of health care professional; - Child JH emergency information did not contain the child’s health care professional name and number. 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 10/18/2023. 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: Today, we discussed the following: - Child OM medical report is due by 10/5/2023. - Ensure the off-premises dates reflect the current school year. - Ensure staff list a health care professional on the emergency information form. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at 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