Montessori Country DAY

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 6/26/2025 Number Present: 43 Completed Date: 6/26/2025 Age: From 1 To 7 Total Minutes: 195 Time In: 10:30 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 me, Dawn McCrary, Child Care Consultant and also signed by Kristina Specht, Director, during the visit. An electronic signed copy of the summary was left on-site. Today, Kristina Specht, Director was 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 ninety (90) percentage as of 6/25/25. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. The last annual compliance visit was conducted on 7/9/24. The last fire drill was practiced on 6/20/25 The last shelter-in-place drill was practiced on 5/5/25 The last playground inspection was documented on 6/23/25 The last fire inspection was approved on 1/15/25 The last sanitation inspection was conducted on 6/19/25 with two (2) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Lead water testing was completed on 11/10/23 with no hazards. Lead paint and asbestos testing enrollment has been completed. During today’s visit, the classroom of one and two-year-old children were having free choice play in the classroom with playdough and books. The classroom of two and three-year-old children were having free choice play in the classroom and having routine care. The classroom of three to seven-year-olds was having free choice play on the playground. The classroom of three to six-year-olds was having free choice play in the classroom with blocks, scissors and table activities. The classroom of four and five-year-olds was having a group book time indoors. All interactions were positive. Supervision was adequate. There are fifty children enrolled. Five child files were monitored for child care requirements. There are three newly hired staff and nine existing staff. The newly hired staff files and one existing staff file were monitored for child care requirements. 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 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 10A NCAC 09 .0701(a) Technical assistance provided as follows: 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS #1032 Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 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 7/10/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Unfortunately, recently there have been deaths of children during rest time in child care facilities in Western North Carolina. Please share, with your staff, the following information to help keep children safe during nap time: Lighting at nap time should allow staff to see the children’s face, skin color, and breathing. Music should be at a low volume and calm so that staff can hear the children breathing and any change in their breathing. Sleep Checks being conducted every 15 minutes till the children are 13 months old. Blankets for older children shall not cover their faces. Supervision is important for the child’s safety, prevention of any injuries, and quality child care. With proper supervision, program staff can quickly remove children from any potential harm. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 6/26/2025 Number Present: 43 Completed Date: 6/26/2025 Age: From 1 To 7 Total Minutes: 195 Time In: 10:30 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 me, Dawn McCrary, Child Care Consultant and also signed by Kristina Specht, Director, during the visit. An electronic signed copy of the summary was left on-site. Today, Kristina Specht, Director was 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 ninety (90) percentage as of 6/25/25. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. The last annual compliance visit was conducted on 7/9/24. The last fire drill was practiced on 6/20/25 The last shelter-in-place drill was practiced on 5/5/25 The last playground inspection was documented on 6/23/25 The last fire inspection was approved on 1/15/25 The last sanitation inspection was conducted on 6/19/25 with two (2) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Lead water testing was completed on 11/10/23 with no hazards. Lead paint and asbestos testing enrollment has been completed. During today’s visit, the classroom of one and two-year-old children were having free choice play in the classroom with playdough and books. The classroom of two and three-year-old children were having free choice play in the classroom and having routine care. The classroom of three to seven-year-olds was having free choice play on the playground. The classroom of three to six-year-olds was having free choice play in the classroom with blocks, scissors and table activities. The classroom of four and five-year-olds was having a group book time indoors. All interactions were positive. Supervision was adequate. There are fifty children enrolled. Five child files were monitored for child care requirements. There are three newly hired staff and nine existing staff. The newly hired staff files and one existing staff file were monitored for child care requirements. 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 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 10A NCAC 09 .0701(a) Technical assistance provided as follows: 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS #1032 Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 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 7/10/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Unfortunately, recently there have been deaths of children during rest time in child care facilities in Western North Carolina. Please share, with your staff, the following information to help keep children safe during nap time: Lighting at nap time should allow staff to see the children’s face, skin color, and breathing. Music should be at a low volume and calm so that staff can hear the children breathing and any change in their breathing. Sleep Checks being conducted every 15 minutes till the children are 13 months old. Blankets for older children shall not cover their faces. Supervision is important for the child’s safety, prevention of any injuries, and quality child care. With proper supervision, program staff can quickly remove children from any potential harm. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 6/26/2025 Number Present: 43 Completed Date: 6/26/2025 Age: From 1 To 7 Total Minutes: 195 Time In: 10:30 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 me, Dawn McCrary, Child Care Consultant and also signed by Kristina Specht, Director, during the visit. An electronic signed copy of the summary was left on-site. Today, Kristina Specht, Director was 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 ninety (90) percentage as of 6/25/25. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. The last annual compliance visit was conducted on 7/9/24. The last fire drill was practiced on 6/20/25 The last shelter-in-place drill was practiced on 5/5/25 The last playground inspection was documented on 6/23/25 The last fire inspection was approved on 1/15/25 The last sanitation inspection was conducted on 6/19/25 with two (2) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Lead water testing was completed on 11/10/23 with no hazards. Lead paint and asbestos testing enrollment has been completed. During today’s visit, the classroom of one and two-year-old children were having free choice play in the classroom with playdough and books. The classroom of two and three-year-old children were having free choice play in the classroom and having routine care. The classroom of three to seven-year-olds was having free choice play on the playground. The classroom of three to six-year-olds was having free choice play in the classroom with blocks, scissors and table activities. The classroom of four and five-year-olds was having a group book time indoors. All interactions were positive. Supervision was adequate. There are fifty children enrolled. Five child files were monitored for child care requirements. There are three newly hired staff and nine existing staff. The newly hired staff files and one existing staff file were monitored for child care requirements. 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 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 10A NCAC 09 .0701(a) Technical assistance provided as follows: 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS #1032 Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 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 7/10/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Unfortunately, recently there have been deaths of children during rest time in child care facilities in Western North Carolina. Please share, with your staff, the following information to help keep children safe during nap time: Lighting at nap time should allow staff to see the children’s face, skin color, and breathing. Music should be at a low volume and calm so that staff can hear the children breathing and any change in their breathing. Sleep Checks being conducted every 15 minutes till the children are 13 months old. Blankets for older children shall not cover their faces. Supervision is important for the child’s safety, prevention of any injuries, and quality child care. With proper supervision, program staff can quickly remove children from any potential harm. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 6/26/2025 Number Present: 43 Completed Date: 6/26/2025 Age: From 1 To 7 Total Minutes: 195 Time In: 10:30 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 me, Dawn McCrary, Child Care Consultant and also signed by Kristina Specht, Director, during the visit. An electronic signed copy of the summary was left on-site. Today, Kristina Specht, Director was 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 ninety (90) percentage as of 6/25/25. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. The last annual compliance visit was conducted on 7/9/24. The last fire drill was practiced on 6/20/25 The last shelter-in-place drill was practiced on 5/5/25 The last playground inspection was documented on 6/23/25 The last fire inspection was approved on 1/15/25 The last sanitation inspection was conducted on 6/19/25 with two (2) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Lead water testing was completed on 11/10/23 with no hazards. Lead paint and asbestos testing enrollment has been completed. During today’s visit, the classroom of one and two-year-old children were having free choice play in the classroom with playdough and books. The classroom of two and three-year-old children were having free choice play in the classroom and having routine care. The classroom of three to seven-year-olds was having free choice play on the playground. The classroom of three to six-year-olds was having free choice play in the classroom with blocks, scissors and table activities. The classroom of four and five-year-olds was having a group book time indoors. All interactions were positive. Supervision was adequate. There are fifty children enrolled. Five child files were monitored for child care requirements. There are three newly hired staff and nine existing staff. The newly hired staff files and one existing staff file were monitored for child care requirements. 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 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 10A NCAC 09 .0701(a) Technical assistance provided as follows: 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS #1032 Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 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 7/10/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Unfortunately, recently there have been deaths of children during rest time in child care facilities in Western North Carolina. Please share, with your staff, the following information to help keep children safe during nap time: Lighting at nap time should allow staff to see the children’s face, skin color, and breathing. Music should be at a low volume and calm so that staff can hear the children breathing and any change in their breathing. Sleep Checks being conducted every 15 minutes till the children are 13 months old. Blankets for older children shall not cover their faces. Supervision is important for the child’s safety, prevention of any injuries, and quality child care. With proper supervision, program staff can quickly remove children from any potential harm. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 6/26/2025 Number Present: 43 Completed Date: 6/26/2025 Age: From 1 To 7 Total Minutes: 195 Time In: 10:30 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 me, Dawn McCrary, Child Care Consultant and also signed by Kristina Specht, Director, during the visit. An electronic signed copy of the summary was left on-site. Today, Kristina Specht, Director was 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 ninety (90) percentage as of 6/25/25. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. The last annual compliance visit was conducted on 7/9/24. The last fire drill was practiced on 6/20/25 The last shelter-in-place drill was practiced on 5/5/25 The last playground inspection was documented on 6/23/25 The last fire inspection was approved on 1/15/25 The last sanitation inspection was conducted on 6/19/25 with two (2) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Lead water testing was completed on 11/10/23 with no hazards. Lead paint and asbestos testing enrollment has been completed. During today’s visit, the classroom of one and two-year-old children were having free choice play in the classroom with playdough and books. The classroom of two and three-year-old children were having free choice play in the classroom and having routine care. The classroom of three to seven-year-olds was having free choice play on the playground. The classroom of three to six-year-olds was having free choice play in the classroom with blocks, scissors and table activities. The classroom of four and five-year-olds was having a group book time indoors. All interactions were positive. Supervision was adequate. There are fifty children enrolled. Five child files were monitored for child care requirements. There are three newly hired staff and nine existing staff. The newly hired staff files and one existing staff file were monitored for child care requirements. 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 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 10A NCAC 09 .0701(a) Technical assistance provided as follows: 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS #1032 Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 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 7/10/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Unfortunately, recently there have been deaths of children during rest time in child care facilities in Western North Carolina. Please share, with your staff, the following information to help keep children safe during nap time: Lighting at nap time should allow staff to see the children’s face, skin color, and breathing. Music should be at a low volume and calm so that staff can hear the children breathing and any change in their breathing. Sleep Checks being conducted every 15 minutes till the children are 13 months old. Blankets for older children shall not cover their faces. Supervision is important for the child’s safety, prevention of any injuries, and quality child care. With proper supervision, program staff can quickly remove children from any potential harm. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 6/26/2025 Number Present: 43 Completed Date: 6/26/2025 Age: From 1 To 7 Total Minutes: 195 Time In: 10:30 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 me, Dawn McCrary, Child Care Consultant and also signed by Kristina Specht, Director, during the visit. An electronic signed copy of the summary was left on-site. Today, Kristina Specht, Director was 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 ninety (90) percentage as of 6/25/25. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. The last annual compliance visit was conducted on 7/9/24. The last fire drill was practiced on 6/20/25 The last shelter-in-place drill was practiced on 5/5/25 The last playground inspection was documented on 6/23/25 The last fire inspection was approved on 1/15/25 The last sanitation inspection was conducted on 6/19/25 with two (2) demerits for a Superior classification. The Emergency Medical Care plan was posted and current. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Lead water testing was completed on 11/10/23 with no hazards. Lead paint and asbestos testing enrollment has been completed. During today’s visit, the classroom of one and two-year-old children were having free choice play in the classroom with playdough and books. The classroom of two and three-year-old children were having free choice play in the classroom and having routine care. The classroom of three to seven-year-olds was having free choice play on the playground. The classroom of three to six-year-olds was having free choice play in the classroom with blocks, scissors and table activities. The classroom of four and five-year-olds was having a group book time indoors. All interactions were positive. Supervision was adequate. There are fifty children enrolled. Five child files were monitored for child care requirements. There are three newly hired staff and nine existing staff. The newly hired staff files and one existing staff file were monitored for child care requirements. 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 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 10A NCAC 09 .0701(a) Technical assistance provided as follows: 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS #1032 Staff, S.B., hired 2/18/25, has a signed medical statement on file dated 2/22/25. 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 7/10/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Unfortunately, recently there have been deaths of children during rest time in child care facilities in Western North Carolina. Please share, with your staff, the following information to help keep children safe during nap time: Lighting at nap time should allow staff to see the children’s face, skin color, and breathing. Music should be at a low volume and calm so that staff can hear the children breathing and any change in their breathing. Sleep Checks being conducted every 15 minutes till the children are 13 months old. Blankets for older children shall not cover their faces. Supervision is important for the child’s safety, prevention of any injuries, and quality child care. With proper supervision, program staff can quickly remove children from any potential harm. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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 .2701 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 2/14/2025 Number Present: 42 Completed Date: 2/14/2025 Age: From 1 To 5 Total Minutes: 295 Time In: 10:00 AM Time Out: 02:55 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Kristina Specht, Director, during the visit. A signed copy of the visit summary was left on site for your records. Permit type- Four Star Child Care License; issued 1/19/24. Special Services/Restrictions- Daytime care only, Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Kristina Specht, Director. Ms. Specht was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the children were observed transitioning outdoors to play, having free choice play in the classrooms, having a group book time, and interacting with the caregivers. The outdoor spaces were monitored. The outdoor play areas offer adequate space for running and vigorous play materials with opportunities to slide, ride trikes, play in sand and water, climb, have ball play, and many other gross motor activities. All interactions were positive. Supervision was adequate. There are (2) newly hired staff. The newly hired staff’s files were monitored. The CPR and FA and other required trainings are all current. This 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 1757 A valid qualification letter was not on file and available to review at the facility. Staff, C.C. has an expired qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical assistance provided as follows: Staff C.C. does not have a valid qualifying letter on file. The staff has completed the required paperwork and fingerprinting and the letter has a status of "in process". SECTION .2700 - CRIMINAL BACKGROUND CHECKS 10A NCAC 09 .2701 SCOPE The rules in this Section shall apply to all child care providers as defined in G.S.110-90.2. The Division, in accordance with G.S.110-90.2, shall determine if an individual is a qualified child care provider. An individual may work or be present in any child care facility during the time the individual holds a valid qualification letter from the Division. 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 2/28/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: Dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 7/9/2024 Number Present: 38 Completed Date: 7/9/2024 Age: From 1 To 6 Total Minutes: 285 Time In: 09:45 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, Dawn McCrary, Child Care Consultant and also signed by you, Kristina Specht, Director. A signed copy of the visit summary was left on-site for you. Today, Kristina Specht, Director, was 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-three (83) percentage as of 7/8/24. Currently this center operates with a Four Star Child Care License, issued 1/19/24, earning four points for staff education, six points for program standards and one quality point. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last Temporary Time Period visit was conducted on 12/7/23. The last fire drill was practiced on 6/7/24. The last shelter in place drill was practiced on 6/20/24. The last playground inspection was documented on 6/7/24. The last fire inspection was approved on 5/8/24. The last sanitation inspection was conducted on 3/5/24 with six (6) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is updated as of 2/5/24. The incident log was current and in use. The curriculum for four-year-old children is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Upon my arrival, I made my presence known to Kristina Specht, Director. The children in classroom one were observed having free choice play on the playground. The children in classroom 2 were having free choice play in the classroom with books, cars and interacting with the caregivers. The children in classroom 3 were observed working puzzles, playing with cars, cutting and gluing, and playing in the water table. The children in classroom 4 were observed playing with cars, sand, and looking at dinosaur books. The children in classroom 5 were observed using dinosaur stencils, playing with a marble maze, and playing with sensory materials. The outdoor playground offers many opportunities for running and vigorous play. The equipment provides opportunities for balancing, riding toys, ball play, sand and water and dramatic play. Portable materials were available to enhance outdoor play. All interactions were positive and nurturing. Supervision was adequate. Fifty (50) children are enrolled. Five (5) children’s files were monitored for child care requirements. There are twelve (12) staff. Four (4) staff files were monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a TB screening/test dated 10/28/21. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. ne (1) staff, per the staff and training worksheets, has an expired emergency information form. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current FA training. One (1) staff, per the staff and training worksheets, had FA training due 1/9/24, and received the training 4/13/24. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR training. One (1) staff, per the staff and training worksheets, had CPR training due 1/9/24, and received the training 4/13/24. .1102(d) Technical assistance was provided as follows: 1034-All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS Required for: All staff, including the director. Item Required: Health Questionnaire; a statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. Two (2) staff, per the staff and training worksheets, have expired health questionnaires. Plan to update the health questionnaire forms prior to expiration by using a calendar to track due dates. 1035-Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. One (1) staff, per the staff and training worksheets, has an expired emergency information form. Plan to update the emergency information forms prior to expiration by using a calendar to track due dates. #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. #1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating they were free of active TB and/or TB test or screening was older than 12 months. One (1) staff (C.S, hired 7/3/23), has a medical report on file dated 7/12/23 and a TB screening/test dated 7/13/23. One (1) staff, (H.B., hired 8/14/23), has a medical report on file dated 10/28/21 and a TB screening/test dated 10/28/21. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified Required for: All staff, including the director and individuals who volunteer more than once per week. Item: Tuberculin (TB) Test or Screening-The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Due Date: On or before first day of work. Plan to have staff, H.B., obtain the existing, or get a TB test immediately. Plan to have future hired staff’s TB results on file on or before first day of work. Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item: Medical Report- A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Plan to have staff, H.B., obtain the existing, or get a valid medical statement immediately. Plan to have future hired staff’s medical statements on file on or before first day of work. #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Two (2) staff, per the staff and training worksheets, do not have current CPR and FA training. One (1) staff, per the staff and training worksheets, had CPR and FA training due 1/9/24, and received the training 4/13/24. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp Plan to use calendar reminders of the 90 day due dates and expiration dates of each staff’s CPR and FA trainings. #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One (1) over the counter medication on-site, in classroom 2, Aquaphor, expired 4/2024. 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. Plan to monitor medications monthly for expirations. 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 7/23/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@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: If you elect to change and/or alter any previously approved spaces used by children as indicated on the indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .0510 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .0606 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .0804 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .0902 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .1801 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .2802 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .2809 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .2818 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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. 110-86 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/7/2023 Number Present: 47 Completed Date: 12/7/2023 Age: From 1 To 5 Total Minutes: 155 Time In: 12:10 PM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements. Dawn McCrary, Child Care Consultant, arrived at approximately 2:15pm. Megan Specht, Assistant Director was on-site and available to answer and ask questions. Kristina Specht, Administrator/Legal Operator, was not on-site during the visit and had already left for the day. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Megan Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht and Megan Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 12/6/23. The last lockdown drill was practiced 10/27/23. The last monthly playground inspection was completed on 12/6/23. The last sanitation inspection was completed on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. A zoning letter dated 10/16/23 was provided today during the visit. The Emergency Preparedness Response (EPR) plan was completed on 10/25/23. The emergency medical care (EMC) plan was posted. The incident log was in use and maintained. The children were observed during lunch, routine care and rest. The children have a nutrition opt-out form on file. There were no new staff. Kristina Specht and Megan Specht would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 2. We discussed the resources available during the 2024-25 prep year. We also discussed the option to complete an Outreach Assessment. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. The Child Care Center Item Number Listing (DCDEE-0357) was used as a basic monitoring tool to assess compliance with applicable child care requirements pertinent to this facility. The following violations of child care requirements were observed: Violation Number Comment Rule 524 When children 3 years and older were in care, screen time was not used to stimulate a developmental domain; was not limited to 30 minutes a day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. .0510(d)(2)(A-C) Technical assistance for correction plan: Item 524 – One (1) child in space #5 was using a tablet on their cot during rest time. The screen time log for the child could not be located prior to 12/6/23. The time documented on the screen time log for 12/6/23 was thirty-five (35) minutes. *Screen Time Screen time can only be offered for up to thirty (30) minutes per day. We discussed that the child may have an Individualized Education Plan (IEP) soon that will allow for additional screen time for the child. 10A NCAC 09 .0510 ACTIVITY AREAS (d) When preschool children three years old and older are in care the following shall apply: (2) when screen time is provided on any electronic media device with a visual display, it shall be: (A) offered to stimulate a developmental domain in accordance with the North Carolina Foundations for Early Learning and Development as referenced in Rule .0508 of this Section; (B) limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and (C) documented on a cumulative log or the activity plan that shall be available for review by the Division. 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 12/21/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 82%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the four (4) points for staff education based on the previous ownership. Program Standards: The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 2 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Explorations with Young Children: A Curriculum Guide from the Bank Street College of Education. Although the curriculum is not approved as of 2023, the previous owner implemented this curriculum and current ownership continues to implement the curriculum at the child care facility. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a) A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. 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. Consultation: We discussed the following child care requirements regarding twelve month olds and under fifteen months of age. The facility does not have any children enrolled under fifteen months of age at this time. 10A NCAC 09 .0102 DEFINITIONS The terms and phrases used in this Chapter are defined as follows except when the context of the rule requires a different meaning. The definitions prescribed in G.S. 110-86 also apply to these Rules. (24) "Infant" means any child from birth through 12 months of age. (49) "Toddler" means any child ages 13 months to 35 months of age. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy… (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. (c) A copy of the center's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the center… 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center… A teacher asked a question about infectious and contagious diseases. We discussed the rule requirement below regarding diarrhea. We also discussed to follow the policies outlined for the facility as well. 10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES (a) Centers may provide care for a mildly ill infant or child older than two months who has a Fahrenheit temperature less than 101 degrees and for infants younger than two months who have a Fahrenheit temperature of less than 100.4 by any method including axillary or orally, so long as the child does not have any of the following: (1) more than two stools above the child’s normal pattern and diarrhea is not contained by a diaper or when toilet-trained children are having accidents; For space #5, we discussed having a different plan for lunch and toileting due to only one (1) teacher being in the classroom and the supervision requirement below. Today children were adequately supervised. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (5) staff must be able to see and hear children aged birth to five years old while the children are eating. You asked about storage of water bottles for children. We discussed the sanitation rule below. 15A NCAC 18A .2804 FOOD SUPPLIES (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of Paragraph (h) of this Rule. Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. We discussed the annual fire inspection is due on or before 8/17/24. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 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. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. Dawn McCrary is assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, 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 .0508 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .0605 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .0608 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 10/13/2023 Number Present: 47 Completed Date: 10/13/2023 Age: From 1 To 5 Total Minutes: 285 Time In: 09:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced on 9/20/23. A shelter-in-place drill or lockdown drill must be practiced this month, October 2023. The last monthly playground inspection was completed on 8/23/23. The last sanitation inspection was conducted on 9/19/23 with seven (7) demerits for a Superior rating. The last approved fire inspection was conducted on 8/17/23. The original fire inspection was collected during the visit today. An approved building inspection was completed on 9/14/23. The original building inspection was collected during the visit today. A zoning letter must be provided during the temporary time period. Administrative, operational, and personnel policies have been reviewed and meet all required topics. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A transfer form was emailed to you today to have the EPR plan transferred due to the ownership change. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, and snack. Children were exploring materials in the classroom independently. Teachers were attentive to the needs of the children, singing songs, and providing positive guidance. The parents bring all snacks and meals for children. Children have a nutrition opt out form on file. Materials were sufficient. Three (3) children files were monitored. There are eleven (11) staff. Four (4) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Space #4, the classroom with preschool children, had an activity plan posted for September 2023. GS 110-91(12); .0508(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A prescription Nystatin in space #2, the classroom with two and three year old children, was stored above five feet instead of being locked. 15A NCAC 18A .2820(d) 848 Questionable medication instructions from parents were followed without signed written dosage instructions received from physician or authorized health professional. There were two children under the age of two in space #1, the classroom with one and two year old children, that had cortisone cream medications and parent authorization forms. The cortisone cream medication stated for children under two years of age to ask a doctor. T 10A NCAC 09 .0803(5) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. One Benadryl medication expired 4/2023 and was located in a lockbox in the kitchen. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The last monthly playground inspection was completed on 8/23/23. .0605(q) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The last updated emergency medical care information for one child was August 2022. Refer to the children record worksheet. .0802(c) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) teacher hired on 10/9/23 does not have the signed acknowledgement in their staff file. .0608(d)(1-4) Technical assistance for correction plan: *Storage of Medication – Corrected during the visit The prescription Nystatin must be locked. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. **Medications The two cortisone creams would need a doctor’s note to accompany the medication authorization from the parents. The Benadryl that expired 4/2023 must be sent home with the child’s parent or discarded. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (5) When questions arise concerning whether any medication should be administered to a child, the caregiver may decline to administer that medication without signed, written dosage instructions from a licensed physician or authorized health professional. (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. *Emergency Medical Care Information for Children The one child must have updated emergency medical care information. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. *Current Activity Plan The activity plan in space #4 must be current. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. *Prevention of Shaken Baby and Abusive Head Trauma Policy The teacher hired on 10/9/23 must have the signed acknowledge of the policy review in their staff file. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Monthly Playground Inspection Playground inspections must be completed monthly. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online on the Division’s website. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 10/27/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment Consultation: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history score for the facility prior to the visit today was 83%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. *Administrators must meet lead teacher and administrator requirements for the position. K.S. must apply for the lead teacher position in WORKS. *Any staff that previously applied for a lead teacher position with a degree in Psychology, Sociology, or Elementary Education may write a letter to WORKS and request a reevaluation of education based on the updated early childhood related degrees. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. It is recommended that you visit www.ncrlap.org for supplemental materials to learn more about the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers an Outreach Assessment and Webinar trainings for staff. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: It is recommended to review medication requirements with all staff. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS We discussed one child’s Epi-pen in space #1 expires 12/31/23. We discussed one staff hired prior to the ownership change had a medical report that needs to be transferred to the form that states the staff is physically and emotionally fit to care for children. We discussed there is an updated version of the NC Summary of the Child Care Law which can be found and printed from the Division’s website. We discussed health and safety trainings cannot be used for new staff orientation. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Reminder – CPR/First Aid training is due for staff within ninety (90) days of employment and must be renewed prior to expiration. We discussed for you to contact the Children and Family Resource Center for additional contacts for CPR/First Aid approved trainers. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The approved training organization list and approved courses can be located on the Division’s website. Reminder – Recognizing and Responding to Suspicions of Child Maltreatment training is due for all staff within ninety (90) days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .0508 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .0608 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .0703 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0801 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .1804 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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 .2318 · Violation

Name of Operation: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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: MONTESSORI COUNTRY DAY Facility ID: 45000427 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 8/21/2023 Number Present: 48 Completed Date: 8/21/2023 Age: From 1 To 5 Total Minutes: 360 Time In: 09:00 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Kristina Specht, Administrator/Legal Operator, and Megan Specht, Assistant Director were on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Kristina Specht, during the visit. An electronic signed copy of the visit summary was electronically emailed to Kristina Specht. Currently this center operates with a Temporary License, issued 7/19/23 and is effective through 1/19/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-five (75) children; and age range; 1-8 years. The Secretary of State website was reviewed today, and the Limited Liability Company, KSpecht, LLC, is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, a classroom from each age range was monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced on 7/10/23. The last monthly playground inspection was completed on 7/7/23. A sanitation inspection has been conducted. However, an inspection report and placard has not been provided by the Henderson County Environmental Specialist yet. An approved fire inspection must be completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter to state the physical address for the facility is zoned for child care use must be completed during the temporary time period. Administrative, operational, and personnel policies must be submitted for review during the temporary time period. Operational and personnel policies were emailed to me by Ms. Specht during the visit today. The Emergency Preparedness Response (EPR) plan must be completed on or before 11/19/23. Ms. Specht completed EPR training on 6/26/23. A shelter-in-place drill and lockdown drill must be practiced once the EPR plan is completed. The emergency medical care (EMC) plan was posted and current. The incident log was in use and maintained. The children were observed in routine care, large group activities, small group activities, outdoor play, lunch, and nap. The parents bring all snacks and meals. Children have a nutrition opt out form on file. Materials were sufficient. Teachers were providing positive guidance and redirection with children. Some teachers singing songs with the children. Three (3) children files were monitored. There are ten (10) staff. Seven (7) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in the rated license cycle for the previous facility, Cohort 2. Information will be forthcoming when approaching the prep year and assessment year. It is voluntary to apply for a two through five star rated license. The temporary license is effective through 1/19/24. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. The red painted, wooden bridge on outdoor space #1 has peeling paint. .0601(c) 847 Parent's medication authorization did not include required information. An Epi-Pen in space #4 did not have parent's authorization form and the medical action plan was not signed by the parent to authorize administration of the medication. Three (3) sunscreen authorizations did not include the name of the child on the medication authorization form for topicals. 10A NCAC 09 .0803(4)(6-9) 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. Hydrocortisone cream located in space #1 expired February 2023. .0803(12) 1030 Application for employment and date of birth was not on file for all staff. One (1) staff hired on 7/20/23 did not have an application for employment on file. Refer to the staff and training worksheet. .0302(d)(1)(A) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One (1) staff hired on 7/20/23 did not have a staff medical report on file. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Four (4) staff had a health questionnaire on file dated 8/17/22. .0701(a) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. Three (3) child files were missing the name of the child on the parent statement for the discipline policy. Refer to the children record worksheet. .1804(b) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One (1) staff hired on 7/20/23 did not have the acknowledgement on file. Refer to the staff and training worksheets. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One (1) staff hired on 4/11/23 does not have documentation on file of completing the training. Refer to the staff and training worksheet. .1102(g) 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. Three (3) child files did not include the name of the child on the acknowledgement. .0608(b)(1-6) Technical assistance for correction plan: **Parent Medication Authorizations The Epi-Pen in space #4 must have parent authorization on the medical action plan or on a medication authorization form. The three (3) sunscreen permissions need the child’s name. The expired hydrocortisone cream from space #1 must be sent home with the child’s parent or discarded. It is recommended to audit all sunscreen to be sure the authorization includes the child’s name. It is recommended to check all medications when provided to the facility to be sure they are not expired. 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: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. *Safe Outdoor Environment The bridge must be removed from outdoor play space #1 until it can be sanded and repainted. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (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) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. *Discipline Policy Statement The child’s name must be added to the discipline policy. It is recommended to audit all child files to be sure the child’s name is on each discipline policy statement. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. **Prevention of Shaken Baby and Abusive Head Trauma Policy Acknowledgement The three (3) child files must have the child’s name on the acknowledgement form. The two (2) staff must have the acknowledgement form completed. It is recommended to audit all child files to be sure the child’s name is on each acknowledgement. The one (1) staff must sign the acknowledgement. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (b) Within 30 days of adopting the policy, the child care center shall review the policy with parents of currently enrolled children up to five years of age. A copy of the policy shall be given and explained to the parents of newly enrolled children up to five years of age on or before the first day the child receives care at the center. The center shall obtain the parent’s signature on the statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain the following and be maintained in the child’s file for review by the Division: (1) The child’s name; (2) The date the child first attended the center; (3) The date the operator’s policy was given and explained to the parent; (4) The parent’s name; (5) The parent’s signature; and (6) The date the parent signed the acknowledgment. (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. *Recognizing and Responding to Suspicions of Child Maltreatment Training The one (1) staff must have documentation on file to complete the training. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. *Application for Employment The one (1) staff must complete an application and place in the respective staff files. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (1) staff records that include: (A) an application for employment and date of birth; (B) documentation of education, training, and experience; (C) medical and health records; (D) documentation of staff orientation, participation in training, and staff development activities; and (E) required criminal history background check documentation; 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (g) Each center shall maintain records as described in 10A NCAC 09 .0302(d) and shall make them available to the Division for review. *Staff Medical Report The one (1) staff must have a staff medical report on file. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report - A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment - When submitted, the medical statement shall not be older than 12 months. *Staff Health Questionnaire - Corrected During the Visit The four (4) staff must complete the health questionnaire annually. We discussed that if there were no changes annually, the staff could indicate no changes on the health questionnaire form, the sign and date. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: All staff, including the director. Item Requirements: Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Due Date: Annually following the initial medical statement. 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 on or before 9/4/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. SACERS-U Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the Environment Rating Scale Assessment score. Display children’s artwork in the classrooms. Include 2-D and 3-D art and craft projects to complete on the activity plan and display. Staff members should sit with children during meals and during snacks. Handwashing is required when: After children use the toilet or after assisting individual children with toileting routines. Immediately before meal or snack preparation and eating as well as after eating. (Remember to avoid recontamination of hands that can occur when unclean surfaces such as floors or toys are touched before eating.) Upon arrival and after outdoor play After messy activities (i.e. sand play, play dough). Before/after group water play After dealing with bodily fluids (i.e. wiping noses, coughing into hands, bandaging a scraped knee), even if gloves are used. Child sized tables and chairs must be correctly sized for at least 75% of children to receive credit. Gross motor equipment must be sturdy, age appropriate and stimulate many skills such as climbing, balancing, hanging by arms, sliding, riding tricycles and bicycles. You must have a variety of portable materials in good repair accessible to play individual and group gross motor games that stimulate many skills. Active play must occur indoors when they cannot not go outdoors due to precipitating weather. Make sure to always follow the weather watch chart to determine if weather is permitting for outdoor activities. Dramatic Play - Staff must extend dramatic play by offering suggestions, finding appropriate space and assisting development of dramatic play roles. Language and reading activities - Children should be encouraged to use reading/writing in practical situations such as reading instructions for games, write letters to friends, and retrieve information online. Math and reasoning - Staff must encourage children to practice math/reasoning skills in daily activities such as recording scores for games, younger children set table with correct number of plates/napkins, measure and cut craft material accurately. Science and nature activities - Some science/nature books must be used to extend children’s information. Such as a book open on table near collection of pinecones and acorns, book about insect specimens and staff use the books to answer children’s questions about materials. Greeting and departing - Staff must acknowledge and personally greet children during arrival and departure. Staff and child communication - Staff and children’s conversations must be frequent. Language should be generally used by staff to exchange information with children and for social interaction. Most of the language observed during the assessment should be personal conversation and talking about topics of mutual interest rather than all directive language. Children should be asked why, how, what if questions that require longer and more complex answers. Children must be free to decide not to participate in any activity they choose. For example, if the teacher does a group time activity, the teacher cannot require all children to participate. Children should be given alternate activities. Tables must be cleaned with soapy water then wiped dry. Then spray with sanitizing solution and let sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. Schedule - At least one fine motor/language activity must be scheduled daily. Staff need to read with children each day. This would be a free choice activity for children to choose to listen to the book. It is recommended to contact Crystal Williams, School-Age Coordinator for Southwestern Child Development Commission, Child Care Resource and Referral - Williams.Crystal@swcdcinc.org. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Child Care Health Consultant for Henderson County, Jennifer Bruni – Jenniferb@childrenandfamily.org, 828.698.0674, ext. 173 Consultation: The rated license dated 5/28/19, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. We discussed there was Benadryl listed on the medication action plan for the child in space #4 with the Epi-Pen. Plan to contact the parent and have them provide the Benadryl. We discussed retention of staff and children files, as well as attendance records. Refer to child care rule 10A NCAC 09 .2318 CHILD CARE CENTER RECORD RETENTION. Ms. Specht stated she sent her official transcripts to the Workforce Education Unit to have education evaluated for the lead teacher and administrator positions. Ms. Specht will need to contact the Workforce Education unit to check in and see if the transcripts were received since there is no education showing in her WORKS account. We further discussed the rule below for lead teacher requirements. 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (c) Within six months of an individual assuming lead teacher or child care administrator duties, each center shall maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. We discussed all blanks on the child application must be completed with answers to all information requested as required in the rule below. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (a) Each child in care shall have an individual application for enrollment completed and signed by the child's parent, as defined in 10A NCAC 09 .0102. The completed, signed application shall be on file in the center on the first day the child attends and shall include the following information: (1) emergency medical information as set forth in Rule .0802(c) of this Section; (2) the child's full name and the name the child is to be called; (3) the child's date of birth; (4) any allergies and the symptoms and type of response required for allergic reactions; (5) any health care needs or concerns, symptoms of and the type of response required for these health care needs or concerns; (6) fears or behavior characteristics that the child has; and (7) the names of individuals to whom the center may release the child, as authorized by the person who signs the application. We discussed easily torn plastics must be stored five feet from the floor in a cabinet or shelf, or locked to make inaccessible 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. We discussed the annual staff development plans and annual evaluations must be completed for any staff from the previous ownership on the same timeline. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. We discussed that activity plans must include the following to meet minimum requirements. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (g) The activity plan shall: (1) identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; (2) reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, as listed in G.S. 110-91(12) as follows: (A) art and other creative play; (B) children's books; (C) blocks and block building; (D) manipulatives; and (E) family living and dramatic play; We discussed the on-going training for staff from the previous ownership must be completed at the staff member’s work anniversary date. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis 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