St. Gerard House - The Grotto Therapeutic Center

10A NCAC 09 .0601 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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 .0604 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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 .0803 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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

GS 110-91 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/29/2026 Number Present: 10 Completed Date: 4/29/2026 Age: From 3 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Andrea Petticrew, Administrator during the visit. Bonnie Mathis, Licensing Supervisor accompanied me on today’s visit. A signed copy of the typed version of the visit summary was left on-site. Due to Regulatory Database issues, a electronic version of today’s visit will be emailed to you. Today, Ms. Petticrew accompanied me through the walkthrough of the facility. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nurture/care treatment of children, 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. Due to Regulatory technical issues, the facility’s compliance history was not available. Once I return to my office, I will verify there are no concerns and follow-up with the administrator as needed. The North Carolina Secretary of State website was viewed today and the non-profit corporation, St. Gerard’s House is current and active. Permit type – One Star Special Services/Restrictions – Daytime care only, Children in care on ground level only, Children under 2 ½ years old in rooms with direct exits only. This program received a temporary license on April 25, 2025. Today is the first full annual compliance since the program was licensed. The last fire drill was practiced on March 31, 2026 The last Lockdown drill was practiced on March 25, 2026 The last playground inspection was documented on April 21, 2026 The last fire inspection was approved on February 27, 2026 The last sanitation inspection was conducted on January 20, 2026 with six (6) demerits for a superior classification. The Emergency Medical Care plan was not posted or current. Lead water testing was completed on November 18, 2025, without hazards. Lead paint and asbestos testing was exempt from testing. Upon arrival we waited for entry and were greeted by the Administrator. We introduced our presence and entered the office area. The facility is set up as one space with separate pods to allow for one-on-one activity with the children. Children were observed engaged in activities with their one-on-one lead teacher. There is an indoor gross motor space that is used and the outdoor space is shared with another licensed child care program. The children enrolled and attending The Grotto uses the outdoor space from 12:00 – 1:00 daily. Families provide the children’s lunch and snack and maintain an opt out nutrition form in their file. 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 program does not provide transportation, but provides off premise activities that are within walking distances. The following violations were documented during today’s visit: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. A daily schedule was not posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A current activity plan was not posted. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. There is exposed concrete at several areas around the fence and at the base of the concrete path. There are exposed nails at the base of the wooden walkway and splintering wood. One (1) tree had a branch at child's level that was sharp. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One (1) electric outlet was uncovered in the resource room. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The alternate person listed on the EMC is no longer employed. .0802(a)(1)(A-B); 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) can of Febreze in an aerosol can was stored in the bathroom unlocked. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. 15A NCAC 18A .2820(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. One (1) Desitin ointment was not accompanied with a parent permission to administer. 10A NCAC 09 .0803(1)(a & b) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Seven (7) staff received 5.5 hours of orientation within the first 2 weeks of employment. .1101(a)(b) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Seven (7) staff were not linked to the ABCMS roster. G.S. 110-90.2 & .2703(r) Technical assistance was provided as follows: Item #415 – A daily schedule was not posted as required. You stated you have a schedule on the computer; however, the schedule needs to be posted for easy access. To achieve compliance, print and review your schedule to determine all required information is listed and posted in an easily accessible area of the classroom. Item #428 – An activity plan was not posted as required. You stated the activity plan is on the computer; however, the plan needs to be posted for easy access. To achieve compliance, print and review the activity plan to ensure all required activities are listed and posted in an easily accessible area of the classroom for reference. Item #807 – There was splintering wood and exposed nails at the base of the wooden walkway accessible to children. Additionally, there is concrete exposed at several locations at the base of the fence and at the concrete path. To achieve compliance additional mulch/dirt needs to be added to cover the exposed concrete. Nails need to be removed, or a board placed over the splintering wood and exposed nails. There is a branch at child’s level that has a sharp edge. The maintenance personnel stating he will cut that off today. Item #812 – One (1) electrical outlet was uncovered in the Resource Room. This was corrected during the visit. Recommend to scan the spaces daily before children arrive to ensure all electrical outlets are covered as required. Item #837 – The Emergency Medical Care (EMC) plan did not contain an employed alternate. Revise the EMC to include an alternative responsible person to Item #840 – An aerosol can of Febreze was located unlocked in the bathroom. This was corrected during the visit. Item #841 – Neosporin, Benadryl, and Bengay Instant Cold Pack was located in the first aid kit in an unlocked cabinet. The items were locked during today’s visit; therefore, corrected during the visit. Item #842 – A Desitin ointment for one (1) child did not have a permission to administer on file. To achieve compliance, have the parent complete and sign a permission to administer Desitin or return the ointment to the parent. Item #1067 – In review of staff files and the staff/training worksheet, seven (7) staff did not receive six hours of orientation within the first two weeks of employment. L.S. has until Friday, May 1st, to complete the 6 hours of orientation. To achieve compliance, the seven (7) staff will need to receive ½ hour of additional orientation training within the specific categories. Item #1805 – Seven (7) staff were not linked to the ABCMS roster with five (5) days of hire as required. To achieve compliance, the staff noted on the staff/training worksheet will need to be linked. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. 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# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by May 13, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) 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: We discussed a staff/child ratio form needs to be posted in each space identifying the number of children allowed. The first aid kit should be store accessible with no hazardous items inside. The first aid is to be easily accessible for staff to retrieve needed items to assist with incidents that may occur. This is a developmental day site and children have specific needs to be met. We observed many screens today being used by both children and staff in a one on one setting. Each child is allowed 30 minutes of screen time daily for a total of 2 ½ hours a week. If more screen time is required based on the child’s developmental need, this information is to be included in the child’s IEP or medical order. When the Emergency medical care plan is revised, please be reminded, the revision will need to be reviewed with all staff. The current administrator is not listed in Regulatory. A copy of the pre-service administrator form was left on-site. Please complete and return at soon as possible so we can update the facility’s information. You have requested to increase your capacity to eleven (11). The building inspection is limited to a maximum of ten (10) children. In order to increase the capacity, you will need to contact the building’s department to request an increase. The building inspector can complete a new building inspection form or provide an addendum on letterhead and signed with approval of eleven (11) children. 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 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 .1801 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: 1025-054L Visit Date: 10/14/2025 Number Present: 10 Completed Date: 10/14/2025 Age: From 3 To 5 Total Minutes: 165 Time In: 08:45 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to investigate allegations of child care requirements. A computerized generated report of the visit was completed, reviewed with you, and signed by me, Monica Houck, Lead Child Care Consultant and also signed by Rachel Smith, Director of Clinical Operations, during the visit. A signed copy of the visit summary was left on-site for you. Ms. Smith assisted me during the visit today, as well as Sophia Greco, Lead Teacher. Ayana Lee, Administrator, is no longer working at the child care facility. The facility operates with a temporary license issued on 4/25/25. Daytime Care only; children in care on ground level only; children under 2.5 years in rooms with direct exits only. The complaint was received by the Division of Child Development and Early Education on 10/6/25 and sent to me on 10/7/25. Children were observed during routine care, outdoor play, and routine therapy sessions. There were twelve (12) caregivers, and ten (10) children present today. There is at least a one (1) to one (1) ratio for staff to children based on the therapy schedules. The incident log was reviewed during the visit. One (1) child file was reviewed during the visit to review incident reports. There is a concern regarding supervision. Based on interviews with staff, an incident report was written on 8/20/25 at 8:20am to document that while a child was in the restroom a teacher noticed bruising on child’s back while assisting the child with wiping. The parent was notified of the observation and signed the incident report. The administrator at the time spoke with the parent and the parent was unaware of anything that occurred to the child on their end or at home. A staff at the child care facility reported the concern about the child’s unexplained bruising to the Henderson County Department of Social Services (DSS). The child did not attend the child care facility starting on 8/21/25 and then returned to care at the child care facility on 9/8/25. The child care staff had a meeting with the parents on 9/4/25 to discuss the child’s return to care at the facility. Staff reported that the child has been supervised and there was no observation of the child falling or hitting anything that would have caused a discoloration or bruising on the child’s back on or a day or two prior to 8/20/25. The staff reported the child generally cries or provides a physical indication, such as pointing to a part of the body, if hurt or injured. Based on observations today, children were adequately supervised. There was at least one teacher for every child. Teachers were engaged with children. Based on staff interviews and observations during the visit, the allegation regarding supervision is unsubstantiated. The following violation of child care requirements was observed: Violation Number Comment Rule 853 Incident logs were not completed and maintained as required. The incident report from 8/20/25 was documented on an incident log not provided by the Division as required. .0802(g)(1-6) 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 • Signed statement of compliance I must receive your compliance statement on or before 10/15/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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 administrative action. The compliance history for the facility prior to today’s visit was eighty-five percent (85%). Achieving Compliance – rule references are noted in the cited violations *Incident Log – Item #853 We discussed that the incident log could be located on the Division’s website under provider forms and documents. Starting today, all incident reports will need to be logged on the incident log form provided by the Division. Consultation is provided as follows: It is recommended to review the child care requirements below with staff. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS The pre-service requirements for administrator form and legal designee information form were emailed to Ms. Smith and Tom Brackett, Legal Operator, to complete and return to me via email on or before 10/15/25 if possible. The temporary license expires on 10/25/25. Once the administrator is assigned, that person is required to have at minimum twenty (20) hours per week on-site at the child care facility. Ms. Smith may be assigned temporarily and will need to apply for the administrator position in her DCDEE WORKS account. We discussed the incident reports need to provide the current facility ID# and the current child care consultant. I provided Dawn McCrary’s business card to you today with her name, email, and phone number. The file for the facility will be transferred to Ms. McCrary once the one-star license is issued. We discussed that anytime a concern is reported to DSS and depending on the specifics of the concern, you can also report the concern to DCDEE as a self-report. We discussed the Emergency Medical Care (EMC) plan will need to be updated with any changes and reviewed with staff. 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 to 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 can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: 1025-054L Visit Date: 10/14/2025 Number Present: 10 Completed Date: 10/14/2025 Age: From 3 To 5 Total Minutes: 165 Time In: 08:45 AM Time Out: 11:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit was to investigate allegations of child care requirements. A computerized generated report of the visit was completed, reviewed with you, and signed by me, Monica Houck, Lead Child Care Consultant and also signed by Rachel Smith, Director of Clinical Operations, during the visit. A signed copy of the visit summary was left on-site for you. Ms. Smith assisted me during the visit today, as well as Sophia Greco, Lead Teacher. Ayana Lee, Administrator, is no longer working at the child care facility. The facility operates with a temporary license issued on 4/25/25. Daytime Care only; children in care on ground level only; children under 2.5 years in rooms with direct exits only. The complaint was received by the Division of Child Development and Early Education on 10/6/25 and sent to me on 10/7/25. Children were observed during routine care, outdoor play, and routine therapy sessions. There were twelve (12) caregivers, and ten (10) children present today. There is at least a one (1) to one (1) ratio for staff to children based on the therapy schedules. The incident log was reviewed during the visit. One (1) child file was reviewed during the visit to review incident reports. There is a concern regarding supervision. Based on interviews with staff, an incident report was written on 8/20/25 at 8:20am to document that while a child was in the restroom a teacher noticed bruising on child’s back while assisting the child with wiping. The parent was notified of the observation and signed the incident report. The administrator at the time spoke with the parent and the parent was unaware of anything that occurred to the child on their end or at home. A staff at the child care facility reported the concern about the child’s unexplained bruising to the Henderson County Department of Social Services (DSS). The child did not attend the child care facility starting on 8/21/25 and then returned to care at the child care facility on 9/8/25. The child care staff had a meeting with the parents on 9/4/25 to discuss the child’s return to care at the facility. Staff reported that the child has been supervised and there was no observation of the child falling or hitting anything that would have caused a discoloration or bruising on the child’s back on or a day or two prior to 8/20/25. The staff reported the child generally cries or provides a physical indication, such as pointing to a part of the body, if hurt or injured. Based on observations today, children were adequately supervised. There was at least one teacher for every child. Teachers were engaged with children. Based on staff interviews and observations during the visit, the allegation regarding supervision is unsubstantiated. The following violation of child care requirements was observed: Violation Number Comment Rule 853 Incident logs were not completed and maintained as required. The incident report from 8/20/25 was documented on an incident log not provided by the Division as required. .0802(g)(1-6) 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 • Signed statement of compliance I must receive your compliance statement on or before 10/15/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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 administrative action. The compliance history for the facility prior to today’s visit was eighty-five percent (85%). Achieving Compliance – rule references are noted in the cited violations *Incident Log – Item #853 We discussed that the incident log could be located on the Division’s website under provider forms and documents. Starting today, all incident reports will need to be logged on the incident log form provided by the Division. Consultation is provided as follows: It is recommended to review the child care requirements below with staff. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS The pre-service requirements for administrator form and legal designee information form were emailed to Ms. Smith and Tom Brackett, Legal Operator, to complete and return to me via email on or before 10/15/25 if possible. The temporary license expires on 10/25/25. Once the administrator is assigned, that person is required to have at minimum twenty (20) hours per week on-site at the child care facility. Ms. Smith may be assigned temporarily and will need to apply for the administrator position in her DCDEE WORKS account. We discussed the incident reports need to provide the current facility ID# and the current child care consultant. I provided Dawn McCrary’s business card to you today with her name, email, and phone number. The file for the facility will be transferred to Ms. McCrary once the one-star license is issued. We discussed that anytime a concern is reported to DSS and depending on the specifics of the concern, you can also report the concern to DCDEE as a self-report. We discussed the Emergency Medical Care (EMC) plan will need to be updated with any changes and reviewed with staff. 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 to 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 can be a resource for you while you strive to provide a safe and healthy environment for the well-being of young children. 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 .0102 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 9/15/2025 Number Present: 8 Completed Date: 9/15/2025 Age: From 3 To 4 Total Minutes: 175 Time In: 10:35 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with applicable child care requirements during the third temporary time period visit. Ayana Lee, Administrator/Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/21/25 was not completed on the form provided by the Division as required; the previously approved fire inspection was conducted on 8/7/24 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; the surveys must be taken to determine if testing is required. During this visit, we walked through the facility observing the indoor and outdoor environment, but a full assessment was not completed for each space. The facility was assessed for supervision, staff/child ratio, and health and safety requirements. Children were observed engaged in free play activities, personal care routines, and group time. Program records, including fire drills and monthly outdoor area inspections were complete and current. I observed children during free play. All children bring snacks and lunch, and have a nutrition opt-out form on file. Program records, including fire drills, emergency drills, and monthly playground inspections were completed and current. Eight (8) existing staff records and one (1) new staff record was reviewed. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was completed on 8/21/25, over 12 months since the previous fire inspection on 8/7/24, and was not completed on a form provided by the Division. 10A NCAC 09 .0304(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Sunscreen was stored below five feet in an unlocked cabinet, in space #1, the classroom with three through five year old children. 15A NCAC 18A .2820(d) 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. First Aid for A. Rosenstein expired on 5/31/25 and First Aid training was taken on 6/25/25. .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. CPR for A. Rosenstein expired on 5/31/25 and CPR training was taken on 6/25/25. .1102(d) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The child care operator has not notified the Division of the twenty-four (24) staff or the legal operator that are hired at the child care facility. G.S. 110-90.2 & .2703(r) 1955 The child care center was not free of lead poisoning hazards as defined in G.S. 1130A-131.7(7). There is no documentation on file to state that the child care facility is free from lead based paint hazards. 10A NCAC 09 .0601(f) 1959 The child care center was not free of asbestos hazards as defined in G.S. 130A-444(2) and 10A NCAC 09 .0102(4). There is no documentation on file to state that the child care facility is free from asbestos hazards. 10A NCAC 09 .0601(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 9/29/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history for the child care facility prior to the visit was eighty-eight percent (88%). Achieving Compliance – rule references are noted in the cited violations *Fire Inspection – Item #106 To achieve compliance, the fire inspection dated 8/21/25 must be completed on a form provided by the Division and a plan must be submitted to state how the next annual fire inspection will be completed within 12 months. The annual fire inspection form is located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. You must complete your next annual fire inspection before 8/21/26. Submit the original completed and approved fire inspection form to your child care consultant within one week after it is completed. Call your licensing consultant with any questions you may have. *Criminal Background Checks – Item #1805 All twenty-four (24) staff associated with the child care facility, including the legal operator, must be assigned to the child care facility in the ABCMS portal. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. *Lead Based Paint and Asbestos Hazards – Items #1955 and #1959 The Clean Classrooms for Carolina Kids account for the child care facility states “enrollment started.” To achieve compliance, the surveys for the lead based paint and asbestos hazards must be completed in the account. The account would then state “survey review by RTI.” You may be required to upload documents regarding the age of the building to determine if lead based paint testing and/or asbestos testing is needed. *CPR and First Aid Training - Items #1048 and #1049 To achieve compliance, a plan must be provided to state how CPR and First Aid training will be taken prior to expiration. We discussed that staff cannot take an online CPR and First Aid training, but can take a blended course through an approved training organization and approved course title. *Medication Storage - Item #841 The cabinet was locked during the visit. This was corrected during the visit. Consultation: We discussed that you are enrolled in EDU 261 and EDU 262. Once completed, plan to send official transcripts to the Workforce Education Unit for evaluation in your WORKS account. The education status letter will need to be on file for you once completed. We discussed the topic of aquatics and that wading pools are prohibited. You plan to only offer water play with a sprinkler, slip and slide, and water tables. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (a) The requirements in this Rule apply to child care center "aquatic activities," which are defined as activities that take place in or around a body of water such as swimming, swimming instruction, wading, and visits to water parks. Aquatic activities do not include water play activities such as water table play, slip and slide activities, or playing in sprinklers. (b) Aquatic activities involving the following are prohibited: (1) hot tubs; (2) spas; (3) saunas or steam rooms; (4) portable wading pools; and (5) natural bodies of water and other unfiltered, nondisinfected containments of water. You have chosen not to apply for a rated license and can do so at any time in the future. A one-star license will be issued and indicate that you did not apply for a rated license. The program is required to follow all applicable minimum licensing requirements. An annual compliance visit will be conducted no later than April 2026. The annual fire inspection form and staff and training worksheet form can be located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. Before your annual compliance visit is due, please complete the staff and training worksheet form and submit to your child care consultant. It is recommended that you submit the staff and training worksheet ninety days from your anticipated annual compliance due date. Sanitation inspections must be completed at least annually. You must have another sanitation inspection completed by April 2026. All staff must have completed the required applicable Health and Safety Training requirements and have documentation on file for review within the first twelve (12) months of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Your file will be transferred to Dawn McCrary, child care consultant after the temporary license time period has ended. You can contact Ms. McCrary at (828) 555-3088 or at: dawn.mccrary@dhhs.nc.gov. Contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov, if you have any questions. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 9/15/2025 Number Present: 8 Completed Date: 9/15/2025 Age: From 3 To 4 Total Minutes: 175 Time In: 10:35 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with applicable child care requirements during the third temporary time period visit. Ayana Lee, Administrator/Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/21/25 was not completed on the form provided by the Division as required; the previously approved fire inspection was conducted on 8/7/24 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; the surveys must be taken to determine if testing is required. During this visit, we walked through the facility observing the indoor and outdoor environment, but a full assessment was not completed for each space. The facility was assessed for supervision, staff/child ratio, and health and safety requirements. Children were observed engaged in free play activities, personal care routines, and group time. Program records, including fire drills and monthly outdoor area inspections were complete and current. I observed children during free play. All children bring snacks and lunch, and have a nutrition opt-out form on file. Program records, including fire drills, emergency drills, and monthly playground inspections were completed and current. Eight (8) existing staff records and one (1) new staff record was reviewed. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was completed on 8/21/25, over 12 months since the previous fire inspection on 8/7/24, and was not completed on a form provided by the Division. 10A NCAC 09 .0304(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Sunscreen was stored below five feet in an unlocked cabinet, in space #1, the classroom with three through five year old children. 15A NCAC 18A .2820(d) 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. First Aid for A. Rosenstein expired on 5/31/25 and First Aid training was taken on 6/25/25. .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. CPR for A. Rosenstein expired on 5/31/25 and CPR training was taken on 6/25/25. .1102(d) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The child care operator has not notified the Division of the twenty-four (24) staff or the legal operator that are hired at the child care facility. G.S. 110-90.2 & .2703(r) 1955 The child care center was not free of lead poisoning hazards as defined in G.S. 1130A-131.7(7). There is no documentation on file to state that the child care facility is free from lead based paint hazards. 10A NCAC 09 .0601(f) 1959 The child care center was not free of asbestos hazards as defined in G.S. 130A-444(2) and 10A NCAC 09 .0102(4). There is no documentation on file to state that the child care facility is free from asbestos hazards. 10A NCAC 09 .0601(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 9/29/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history for the child care facility prior to the visit was eighty-eight percent (88%). Achieving Compliance – rule references are noted in the cited violations *Fire Inspection – Item #106 To achieve compliance, the fire inspection dated 8/21/25 must be completed on a form provided by the Division and a plan must be submitted to state how the next annual fire inspection will be completed within 12 months. The annual fire inspection form is located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. You must complete your next annual fire inspection before 8/21/26. Submit the original completed and approved fire inspection form to your child care consultant within one week after it is completed. Call your licensing consultant with any questions you may have. *Criminal Background Checks – Item #1805 All twenty-four (24) staff associated with the child care facility, including the legal operator, must be assigned to the child care facility in the ABCMS portal. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. *Lead Based Paint and Asbestos Hazards – Items #1955 and #1959 The Clean Classrooms for Carolina Kids account for the child care facility states “enrollment started.” To achieve compliance, the surveys for the lead based paint and asbestos hazards must be completed in the account. The account would then state “survey review by RTI.” You may be required to upload documents regarding the age of the building to determine if lead based paint testing and/or asbestos testing is needed. *CPR and First Aid Training - Items #1048 and #1049 To achieve compliance, a plan must be provided to state how CPR and First Aid training will be taken prior to expiration. We discussed that staff cannot take an online CPR and First Aid training, but can take a blended course through an approved training organization and approved course title. *Medication Storage - Item #841 The cabinet was locked during the visit. This was corrected during the visit. Consultation: We discussed that you are enrolled in EDU 261 and EDU 262. Once completed, plan to send official transcripts to the Workforce Education Unit for evaluation in your WORKS account. The education status letter will need to be on file for you once completed. We discussed the topic of aquatics and that wading pools are prohibited. You plan to only offer water play with a sprinkler, slip and slide, and water tables. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (a) The requirements in this Rule apply to child care center "aquatic activities," which are defined as activities that take place in or around a body of water such as swimming, swimming instruction, wading, and visits to water parks. Aquatic activities do not include water play activities such as water table play, slip and slide activities, or playing in sprinklers. (b) Aquatic activities involving the following are prohibited: (1) hot tubs; (2) spas; (3) saunas or steam rooms; (4) portable wading pools; and (5) natural bodies of water and other unfiltered, nondisinfected containments of water. You have chosen not to apply for a rated license and can do so at any time in the future. A one-star license will be issued and indicate that you did not apply for a rated license. The program is required to follow all applicable minimum licensing requirements. An annual compliance visit will be conducted no later than April 2026. The annual fire inspection form and staff and training worksheet form can be located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. Before your annual compliance visit is due, please complete the staff and training worksheet form and submit to your child care consultant. It is recommended that you submit the staff and training worksheet ninety days from your anticipated annual compliance due date. Sanitation inspections must be completed at least annually. You must have another sanitation inspection completed by April 2026. All staff must have completed the required applicable Health and Safety Training requirements and have documentation on file for review within the first twelve (12) months of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Your file will be transferred to Dawn McCrary, child care consultant after the temporary license time period has ended. You can contact Ms. McCrary at (828) 555-3088 or at: dawn.mccrary@dhhs.nc.gov. Contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov, if you have any questions. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 9/15/2025 Number Present: 8 Completed Date: 9/15/2025 Age: From 3 To 4 Total Minutes: 175 Time In: 10:35 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with applicable child care requirements during the third temporary time period visit. Ayana Lee, Administrator/Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/21/25 was not completed on the form provided by the Division as required; the previously approved fire inspection was conducted on 8/7/24 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; the surveys must be taken to determine if testing is required. During this visit, we walked through the facility observing the indoor and outdoor environment, but a full assessment was not completed for each space. The facility was assessed for supervision, staff/child ratio, and health and safety requirements. Children were observed engaged in free play activities, personal care routines, and group time. Program records, including fire drills and monthly outdoor area inspections were complete and current. I observed children during free play. All children bring snacks and lunch, and have a nutrition opt-out form on file. Program records, including fire drills, emergency drills, and monthly playground inspections were completed and current. Eight (8) existing staff records and one (1) new staff record was reviewed. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was completed on 8/21/25, over 12 months since the previous fire inspection on 8/7/24, and was not completed on a form provided by the Division. 10A NCAC 09 .0304(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Sunscreen was stored below five feet in an unlocked cabinet, in space #1, the classroom with three through five year old children. 15A NCAC 18A .2820(d) 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. First Aid for A. Rosenstein expired on 5/31/25 and First Aid training was taken on 6/25/25. .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. CPR for A. Rosenstein expired on 5/31/25 and CPR training was taken on 6/25/25. .1102(d) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The child care operator has not notified the Division of the twenty-four (24) staff or the legal operator that are hired at the child care facility. G.S. 110-90.2 & .2703(r) 1955 The child care center was not free of lead poisoning hazards as defined in G.S. 1130A-131.7(7). There is no documentation on file to state that the child care facility is free from lead based paint hazards. 10A NCAC 09 .0601(f) 1959 The child care center was not free of asbestos hazards as defined in G.S. 130A-444(2) and 10A NCAC 09 .0102(4). There is no documentation on file to state that the child care facility is free from asbestos hazards. 10A NCAC 09 .0601(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 9/29/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history for the child care facility prior to the visit was eighty-eight percent (88%). Achieving Compliance – rule references are noted in the cited violations *Fire Inspection – Item #106 To achieve compliance, the fire inspection dated 8/21/25 must be completed on a form provided by the Division and a plan must be submitted to state how the next annual fire inspection will be completed within 12 months. The annual fire inspection form is located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. You must complete your next annual fire inspection before 8/21/26. Submit the original completed and approved fire inspection form to your child care consultant within one week after it is completed. Call your licensing consultant with any questions you may have. *Criminal Background Checks – Item #1805 All twenty-four (24) staff associated with the child care facility, including the legal operator, must be assigned to the child care facility in the ABCMS portal. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. *Lead Based Paint and Asbestos Hazards – Items #1955 and #1959 The Clean Classrooms for Carolina Kids account for the child care facility states “enrollment started.” To achieve compliance, the surveys for the lead based paint and asbestos hazards must be completed in the account. The account would then state “survey review by RTI.” You may be required to upload documents regarding the age of the building to determine if lead based paint testing and/or asbestos testing is needed. *CPR and First Aid Training - Items #1048 and #1049 To achieve compliance, a plan must be provided to state how CPR and First Aid training will be taken prior to expiration. We discussed that staff cannot take an online CPR and First Aid training, but can take a blended course through an approved training organization and approved course title. *Medication Storage - Item #841 The cabinet was locked during the visit. This was corrected during the visit. Consultation: We discussed that you are enrolled in EDU 261 and EDU 262. Once completed, plan to send official transcripts to the Workforce Education Unit for evaluation in your WORKS account. The education status letter will need to be on file for you once completed. We discussed the topic of aquatics and that wading pools are prohibited. You plan to only offer water play with a sprinkler, slip and slide, and water tables. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (a) The requirements in this Rule apply to child care center "aquatic activities," which are defined as activities that take place in or around a body of water such as swimming, swimming instruction, wading, and visits to water parks. Aquatic activities do not include water play activities such as water table play, slip and slide activities, or playing in sprinklers. (b) Aquatic activities involving the following are prohibited: (1) hot tubs; (2) spas; (3) saunas or steam rooms; (4) portable wading pools; and (5) natural bodies of water and other unfiltered, nondisinfected containments of water. You have chosen not to apply for a rated license and can do so at any time in the future. A one-star license will be issued and indicate that you did not apply for a rated license. The program is required to follow all applicable minimum licensing requirements. An annual compliance visit will be conducted no later than April 2026. The annual fire inspection form and staff and training worksheet form can be located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. Before your annual compliance visit is due, please complete the staff and training worksheet form and submit to your child care consultant. It is recommended that you submit the staff and training worksheet ninety days from your anticipated annual compliance due date. Sanitation inspections must be completed at least annually. You must have another sanitation inspection completed by April 2026. All staff must have completed the required applicable Health and Safety Training requirements and have documentation on file for review within the first twelve (12) months of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Your file will be transferred to Dawn McCrary, child care consultant after the temporary license time period has ended. You can contact Ms. McCrary at (828) 555-3088 or at: dawn.mccrary@dhhs.nc.gov. Contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov, if you have any questions. 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 .1403 · Violation

Name of Operation: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 9/15/2025 Number Present: 8 Completed Date: 9/15/2025 Age: From 3 To 4 Total Minutes: 175 Time In: 10:35 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with applicable child care requirements during the third temporary time period visit. Ayana Lee, Administrator/Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/21/25 was not completed on the form provided by the Division as required; the previously approved fire inspection was conducted on 8/7/24 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; the surveys must be taken to determine if testing is required. During this visit, we walked through the facility observing the indoor and outdoor environment, but a full assessment was not completed for each space. The facility was assessed for supervision, staff/child ratio, and health and safety requirements. Children were observed engaged in free play activities, personal care routines, and group time. Program records, including fire drills and monthly outdoor area inspections were complete and current. I observed children during free play. All children bring snacks and lunch, and have a nutrition opt-out form on file. Program records, including fire drills, emergency drills, and monthly playground inspections were completed and current. Eight (8) existing staff records and one (1) new staff record was reviewed. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was completed on 8/21/25, over 12 months since the previous fire inspection on 8/7/24, and was not completed on a form provided by the Division. 10A NCAC 09 .0304(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Sunscreen was stored below five feet in an unlocked cabinet, in space #1, the classroom with three through five year old children. 15A NCAC 18A .2820(d) 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. First Aid for A. Rosenstein expired on 5/31/25 and First Aid training was taken on 6/25/25. .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. CPR for A. Rosenstein expired on 5/31/25 and CPR training was taken on 6/25/25. .1102(d) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The child care operator has not notified the Division of the twenty-four (24) staff or the legal operator that are hired at the child care facility. G.S. 110-90.2 & .2703(r) 1955 The child care center was not free of lead poisoning hazards as defined in G.S. 1130A-131.7(7). There is no documentation on file to state that the child care facility is free from lead based paint hazards. 10A NCAC 09 .0601(f) 1959 The child care center was not free of asbestos hazards as defined in G.S. 130A-444(2) and 10A NCAC 09 .0102(4). There is no documentation on file to state that the child care facility is free from asbestos hazards. 10A NCAC 09 .0601(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 9/29/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history for the child care facility prior to the visit was eighty-eight percent (88%). Achieving Compliance – rule references are noted in the cited violations *Fire Inspection – Item #106 To achieve compliance, the fire inspection dated 8/21/25 must be completed on a form provided by the Division and a plan must be submitted to state how the next annual fire inspection will be completed within 12 months. The annual fire inspection form is located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. You must complete your next annual fire inspection before 8/21/26. Submit the original completed and approved fire inspection form to your child care consultant within one week after it is completed. Call your licensing consultant with any questions you may have. *Criminal Background Checks – Item #1805 All twenty-four (24) staff associated with the child care facility, including the legal operator, must be assigned to the child care facility in the ABCMS portal. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. *Lead Based Paint and Asbestos Hazards – Items #1955 and #1959 The Clean Classrooms for Carolina Kids account for the child care facility states “enrollment started.” To achieve compliance, the surveys for the lead based paint and asbestos hazards must be completed in the account. The account would then state “survey review by RTI.” You may be required to upload documents regarding the age of the building to determine if lead based paint testing and/or asbestos testing is needed. *CPR and First Aid Training - Items #1048 and #1049 To achieve compliance, a plan must be provided to state how CPR and First Aid training will be taken prior to expiration. We discussed that staff cannot take an online CPR and First Aid training, but can take a blended course through an approved training organization and approved course title. *Medication Storage - Item #841 The cabinet was locked during the visit. This was corrected during the visit. Consultation: We discussed that you are enrolled in EDU 261 and EDU 262. Once completed, plan to send official transcripts to the Workforce Education Unit for evaluation in your WORKS account. The education status letter will need to be on file for you once completed. We discussed the topic of aquatics and that wading pools are prohibited. You plan to only offer water play with a sprinkler, slip and slide, and water tables. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (a) The requirements in this Rule apply to child care center "aquatic activities," which are defined as activities that take place in or around a body of water such as swimming, swimming instruction, wading, and visits to water parks. Aquatic activities do not include water play activities such as water table play, slip and slide activities, or playing in sprinklers. (b) Aquatic activities involving the following are prohibited: (1) hot tubs; (2) spas; (3) saunas or steam rooms; (4) portable wading pools; and (5) natural bodies of water and other unfiltered, nondisinfected containments of water. You have chosen not to apply for a rated license and can do so at any time in the future. A one-star license will be issued and indicate that you did not apply for a rated license. The program is required to follow all applicable minimum licensing requirements. An annual compliance visit will be conducted no later than April 2026. The annual fire inspection form and staff and training worksheet form can be located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. Before your annual compliance visit is due, please complete the staff and training worksheet form and submit to your child care consultant. It is recommended that you submit the staff and training worksheet ninety days from your anticipated annual compliance due date. Sanitation inspections must be completed at least annually. You must have another sanitation inspection completed by April 2026. All staff must have completed the required applicable Health and Safety Training requirements and have documentation on file for review within the first twelve (12) months of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Your file will be transferred to Dawn McCrary, child care consultant after the temporary license time period has ended. You can contact Ms. McCrary at (828) 555-3088 or at: dawn.mccrary@dhhs.nc.gov. Contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov, if you have any questions. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 9/15/2025 Number Present: 8 Completed Date: 9/15/2025 Age: From 3 To 4 Total Minutes: 175 Time In: 10:35 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with applicable child care requirements during the third temporary time period visit. Ayana Lee, Administrator/Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/21/25 was not completed on the form provided by the Division as required; the previously approved fire inspection was conducted on 8/7/24 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; the surveys must be taken to determine if testing is required. During this visit, we walked through the facility observing the indoor and outdoor environment, but a full assessment was not completed for each space. The facility was assessed for supervision, staff/child ratio, and health and safety requirements. Children were observed engaged in free play activities, personal care routines, and group time. Program records, including fire drills and monthly outdoor area inspections were complete and current. I observed children during free play. All children bring snacks and lunch, and have a nutrition opt-out form on file. Program records, including fire drills, emergency drills, and monthly playground inspections were completed and current. Eight (8) existing staff records and one (1) new staff record was reviewed. The following violations of child care requirements were observed today: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last fire inspection was completed on 8/21/25, over 12 months since the previous fire inspection on 8/7/24, and was not completed on a form provided by the Division. 10A NCAC 09 .0304(a) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Sunscreen was stored below five feet in an unlocked cabinet, in space #1, the classroom with three through five year old children. 15A NCAC 18A .2820(d) 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. First Aid for A. Rosenstein expired on 5/31/25 and First Aid training was taken on 6/25/25. .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. CPR for A. Rosenstein expired on 5/31/25 and CPR training was taken on 6/25/25. .1102(d) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The child care operator has not notified the Division of the twenty-four (24) staff or the legal operator that are hired at the child care facility. G.S. 110-90.2 & .2703(r) 1955 The child care center was not free of lead poisoning hazards as defined in G.S. 1130A-131.7(7). There is no documentation on file to state that the child care facility is free from lead based paint hazards. 10A NCAC 09 .0601(f) 1959 The child care center was not free of asbestos hazards as defined in G.S. 130A-444(2) and 10A NCAC 09 .0102(4). There is no documentation on file to state that the child care facility is free from asbestos hazards. 10A NCAC 09 .0601(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 9/29/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history for the child care facility prior to the visit was eighty-eight percent (88%). Achieving Compliance – rule references are noted in the cited violations *Fire Inspection – Item #106 To achieve compliance, the fire inspection dated 8/21/25 must be completed on a form provided by the Division and a plan must be submitted to state how the next annual fire inspection will be completed within 12 months. The annual fire inspection form is located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. You must complete your next annual fire inspection before 8/21/26. Submit the original completed and approved fire inspection form to your child care consultant within one week after it is completed. Call your licensing consultant with any questions you may have. *Criminal Background Checks – Item #1805 All twenty-four (24) staff associated with the child care facility, including the legal operator, must be assigned to the child care facility in the ABCMS portal. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. *Lead Based Paint and Asbestos Hazards – Items #1955 and #1959 The Clean Classrooms for Carolina Kids account for the child care facility states “enrollment started.” To achieve compliance, the surveys for the lead based paint and asbestos hazards must be completed in the account. The account would then state “survey review by RTI.” You may be required to upload documents regarding the age of the building to determine if lead based paint testing and/or asbestos testing is needed. *CPR and First Aid Training - Items #1048 and #1049 To achieve compliance, a plan must be provided to state how CPR and First Aid training will be taken prior to expiration. We discussed that staff cannot take an online CPR and First Aid training, but can take a blended course through an approved training organization and approved course title. *Medication Storage - Item #841 The cabinet was locked during the visit. This was corrected during the visit. Consultation: We discussed that you are enrolled in EDU 261 and EDU 262. Once completed, plan to send official transcripts to the Workforce Education Unit for evaluation in your WORKS account. The education status letter will need to be on file for you once completed. We discussed the topic of aquatics and that wading pools are prohibited. You plan to only offer water play with a sprinkler, slip and slide, and water tables. 10A NCAC 09 .1403 ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS (a) The requirements in this Rule apply to child care center "aquatic activities," which are defined as activities that take place in or around a body of water such as swimming, swimming instruction, wading, and visits to water parks. Aquatic activities do not include water play activities such as water table play, slip and slide activities, or playing in sprinklers. (b) Aquatic activities involving the following are prohibited: (1) hot tubs; (2) spas; (3) saunas or steam rooms; (4) portable wading pools; and (5) natural bodies of water and other unfiltered, nondisinfected containments of water. You have chosen not to apply for a rated license and can do so at any time in the future. A one-star license will be issued and indicate that you did not apply for a rated license. The program is required to follow all applicable minimum licensing requirements. An annual compliance visit will be conducted no later than April 2026. The annual fire inspection form and staff and training worksheet form can be located on the Division’s website under the provider tab, then provider documents and forms tab at https://ncchildcare.ncdhhs.gov/. Before your annual compliance visit is due, please complete the staff and training worksheet form and submit to your child care consultant. It is recommended that you submit the staff and training worksheet ninety days from your anticipated annual compliance due date. Sanitation inspections must be completed at least annually. You must have another sanitation inspection completed by April 2026. All staff must have completed the required applicable Health and Safety Training requirements and have documentation on file for review within the first twelve (12) months of employment. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Your file will be transferred to Dawn McCrary, child care consultant after the temporary license time period has ended. You can contact Ms. McCrary at (828) 555-3088 or at: dawn.mccrary@dhhs.nc.gov. Contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov, if you have any questions. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 7/30/2025 Number Present: 9 Completed Date: 7/30/2025 Age: From 2 To 5 Total Minutes: 220 Time In: 09:05 AM Time Out: 12:45 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 second temporary time period visit. Ayana Lee, Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/7/24, Daytime Care Only; the next fire inspection is due on or before 8/7/25 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; plan to take survey to determine if testing is required. Three (3) children’s files were reviewed. There are twenty-four (24) staff. Eight (8) staff files were reviewed. I observed children during free play, small group activities, outdoor play, and routine care. All children bring snacks and lunch, and have a nutrition opt-out form on file. The facility does not provide transportation, and children do not participate in aquatic activities. You plan to transition to a one-star license. You stated no children will be served through subsidy vouchers and there are no plans to apply for a star rated license. 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 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. There were five (5) expired bottles of babyganics sunscreen that belonged to the facility to use on children on water days. The sunscreen expired in May 2025. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The entry into the classroom with cubbies had packages of diapers wrapped in plastic with a warning to keep out of reach of children that were stored below five feet. The bathroom had packages of diapers wrapped in plastic with a warning to keep out of reach of children that were stored below five feet under the diaper changing table. The bathroom had a soft plastic wipes container that was stored below five feet on top of the diaper changing table with a warning to keep out of reach of children. .0604(q) 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 • Signed statement of compliance I must receive your compliance statement on or before 8/13/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history of the facility prior to the visit today was eighty-four percent (84%). Achieving Compliance – rule references are noted in the cited violations *Item #858 The diapers in the cubbies were stored moved above five feet on top of the cubbies. The diapers and wipes in the bathroom were locked in the storage area of the diaper changing table. This was corrected during the visit. *Item #849 Authorization is considered expired once the sunscreen expires. The sunscreen cannot be used on children at the facility since it has expired. We discussed that new babyganics sunscreen that has not expired could be purchased and used on the children for the next water day to align with the current authorization form. If a different brand of sunscreen is purchased, then a new authorization form will need to be completed. Consultation: We discussed that you have enrolled in EDU 261 and that proof of enrollment with the pre-service requirements for administrator form would need to be emailed to me to move forward to change administrator status to you. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. The next fire inspection is due on or before 8/7/25. 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. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 7/30/2025 Number Present: 9 Completed Date: 7/30/2025 Age: From 2 To 5 Total Minutes: 220 Time In: 09:05 AM Time Out: 12:45 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 second temporary time period visit. Ayana Lee, Program Manager, assisted with the visit and was able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/7/24, Daytime Care Only; the next fire inspection is due on or before 8/7/25 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits Water Lead Testing – 11/17/23 with no hazards identified Lead based paint and asbestos testing – enrollment started; plan to take survey to determine if testing is required. Three (3) children’s files were reviewed. There are twenty-four (24) staff. Eight (8) staff files were reviewed. I observed children during free play, small group activities, outdoor play, and routine care. All children bring snacks and lunch, and have a nutrition opt-out form on file. The facility does not provide transportation, and children do not participate in aquatic activities. You plan to transition to a one-star license. You stated no children will be served through subsidy vouchers and there are no plans to apply for a star rated license. 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 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. There were five (5) expired bottles of babyganics sunscreen that belonged to the facility to use on children on water days. The sunscreen expired in May 2025. .0803(12) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The entry into the classroom with cubbies had packages of diapers wrapped in plastic with a warning to keep out of reach of children that were stored below five feet. The bathroom had packages of diapers wrapped in plastic with a warning to keep out of reach of children that were stored below five feet under the diaper changing table. The bathroom had a soft plastic wipes container that was stored below five feet on top of the diaper changing table with a warning to keep out of reach of children. .0604(q) 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 • Signed statement of compliance I must receive your compliance statement on or before 8/13/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. The compliance history of the facility prior to the visit today was eighty-four percent (84%). Achieving Compliance – rule references are noted in the cited violations *Item #858 The diapers in the cubbies were stored moved above five feet on top of the cubbies. The diapers and wipes in the bathroom were locked in the storage area of the diaper changing table. This was corrected during the visit. *Item #849 Authorization is considered expired once the sunscreen expires. The sunscreen cannot be used on children at the facility since it has expired. We discussed that new babyganics sunscreen that has not expired could be purchased and used on the children for the next water day to align with the current authorization form. If a different brand of sunscreen is purchased, then a new authorization form will need to be completed. Consultation: We discussed that you have enrolled in EDU 261 and that proof of enrollment with the pre-service requirements for administrator form would need to be emailed to me to move forward to change administrator status to you. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. The next fire inspection is due on or before 8/7/25. 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. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 5/22/2025 Number Present: 8 Completed Date: 5/22/2025 Age: From 3 To 6 Total Minutes: 305 Time In: 10:25 AM Time Out: 03:30 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. The program is on a temporary license due to a separation of license from another facility. Bertha Medina, Executive Assistant to CCO, and Ayana Lee, Program Manager, assisted with the visit and were able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/7/24, Daytime Care Only; the next fire inspection is due on or before August 2025 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits. Three (3) children’s files were reviewed. There are twenty-four (24) staff. Eight (8) staff files were reviewed. I observed children during free play and routine care. All children bring snacks and lunch, and have a nutrition opt-out form on file. The facility does not provide transportation, and children do not participate in aquatic activities. The facility must transition to a three-star license or higher to serve children on subsidy vouchers. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. You stated no children will be served through subsidy vouchers and there are no plans to apply for a star rated license. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The last fire drill documented on the emergency log was dated 3/27/25. .0604(t); .0302(d)(5) 825 Before staff members walked children off premises for play or outings, the center did not obtain written permission from the parent of each child. A five year old child was walked off premises without parent permission for the length of time and specific location of the activity for the child. .1005(b)(3) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. An A and D Ointment and Act Bubble Gum toothpaste in space #1, the main classroom for children ages 3 through 6, was located below five feet in children's cubbies. In space #1, four packages of baby wipes with the warning "keep out of reach of children" were located below five feet in a child's cubby. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. An Act Bubble Gum toothpaste did not have a medication authorization form on file for the child. 10A NCAC 09 .0803(4)(6-9) 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 staff hired on 3/15/21 had a medical report dated 3/8/21 that did not specify that the staff was physically and emotionally fit to care for children. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The staff hired on 10/14/18 had an annual staff evaluation on file dated 12/1/22. 10A NCAC 09 .0514(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 6/5/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. Achieving Compliance – rule references are noted in the cited violations *Off Premise Activities - Item #825 We discussed that parent's must know where their child is at all times. An off premise activity is intended to be a special event that takes place away from license space. You stated the child's parents signed a treatment plan to allow the child to go up the stairs at the licensed facility address to transition to a larger setting. We discussed that you do have a restriction on your permit that only allows for the care of children on ground level. The second story of the building does not meet building and fire codes for safe evacuation of children in care at the licensed facility. You stated the transition for the child will pause. For any child participating in an off premise activity, the parent must provide permission for the specific date, time, and place the child will be going and all safety requirements must be met. An off-premise permission form can be located on the Division's website. *Medication Permission - Item #847 We discussed there must be a permission form for any toothpaste for children. You can find the topical permission form on the DCDEE website. *Storage of medication and products labeled keep out of reach of children - Item #841 Any product labeled keep out of reach of children must be stored at least five feet above the floor. Diaper creams must also be kept at least five feet off the floor. 15A NCAC 18A .2820 STORAGE (c) and (d) *Fire Drill - Item #805 You stated a fire drill was completed on 4/30/25 and had not been recorded. Fire drills must be recorded directly after they occur. To achieve compliance, provide a plan on how fire drills will be recorded once they occur. *Staff Files - Items #1032 and We discussed that you could provide the DCDEE staff medical report form for the required information. It is recommended to use the form from the Division's website. A.P. must have an annual evaluation completed. Rated License Consultation It is recommended that you visit www.ncrlap.org for supplemental materials if you choose to apply for a star rated license and prepare for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Consultation: We discussed that Thomas Bracket has been designated the legal operator and facility contact of the licensed child care facility. All paperwork has been completed and submitted to make the change in the Regulatory system. The email address for the facility contact has been changed from bertha@stgerardhouse.org to tom.brackett@stgerardhouse.org. We discussed that the TB test or TB screening date of completion would be documented on the staff and training worksheet to know that the staff had TB test results on or before the first day of work. The EPR plan needs an updated Child Care Health Consultant (CCHC). We discussed that the Henderson County CCHC is Patricia Lee, 828.513.0025 or plee.cchc@gmail.com. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 5/22/2025 Number Present: 8 Completed Date: 5/22/2025 Age: From 3 To 6 Total Minutes: 305 Time In: 10:25 AM Time Out: 03:30 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. The program is on a temporary license due to a separation of license from another facility. Bertha Medina, Executive Assistant to CCO, and Ayana Lee, Program Manager, assisted with the visit and were able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/7/24, Daytime Care Only; the next fire inspection is due on or before August 2025 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits. Three (3) children’s files were reviewed. There are twenty-four (24) staff. Eight (8) staff files were reviewed. I observed children during free play and routine care. All children bring snacks and lunch, and have a nutrition opt-out form on file. The facility does not provide transportation, and children do not participate in aquatic activities. The facility must transition to a three-star license or higher to serve children on subsidy vouchers. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. You stated no children will be served through subsidy vouchers and there are no plans to apply for a star rated license. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The last fire drill documented on the emergency log was dated 3/27/25. .0604(t); .0302(d)(5) 825 Before staff members walked children off premises for play or outings, the center did not obtain written permission from the parent of each child. A five year old child was walked off premises without parent permission for the length of time and specific location of the activity for the child. .1005(b)(3) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. An A and D Ointment and Act Bubble Gum toothpaste in space #1, the main classroom for children ages 3 through 6, was located below five feet in children's cubbies. In space #1, four packages of baby wipes with the warning "keep out of reach of children" were located below five feet in a child's cubby. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. An Act Bubble Gum toothpaste did not have a medication authorization form on file for the child. 10A NCAC 09 .0803(4)(6-9) 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 staff hired on 3/15/21 had a medical report dated 3/8/21 that did not specify that the staff was physically and emotionally fit to care for children. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The staff hired on 10/14/18 had an annual staff evaluation on file dated 12/1/22. 10A NCAC 09 .0514(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 6/5/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. Achieving Compliance – rule references are noted in the cited violations *Off Premise Activities - Item #825 We discussed that parent's must know where their child is at all times. An off premise activity is intended to be a special event that takes place away from license space. You stated the child's parents signed a treatment plan to allow the child to go up the stairs at the licensed facility address to transition to a larger setting. We discussed that you do have a restriction on your permit that only allows for the care of children on ground level. The second story of the building does not meet building and fire codes for safe evacuation of children in care at the licensed facility. You stated the transition for the child will pause. For any child participating in an off premise activity, the parent must provide permission for the specific date, time, and place the child will be going and all safety requirements must be met. An off-premise permission form can be located on the Division's website. *Medication Permission - Item #847 We discussed there must be a permission form for any toothpaste for children. You can find the topical permission form on the DCDEE website. *Storage of medication and products labeled keep out of reach of children - Item #841 Any product labeled keep out of reach of children must be stored at least five feet above the floor. Diaper creams must also be kept at least five feet off the floor. 15A NCAC 18A .2820 STORAGE (c) and (d) *Fire Drill - Item #805 You stated a fire drill was completed on 4/30/25 and had not been recorded. Fire drills must be recorded directly after they occur. To achieve compliance, provide a plan on how fire drills will be recorded once they occur. *Staff Files - Items #1032 and We discussed that you could provide the DCDEE staff medical report form for the required information. It is recommended to use the form from the Division's website. A.P. must have an annual evaluation completed. Rated License Consultation It is recommended that you visit www.ncrlap.org for supplemental materials if you choose to apply for a star rated license and prepare for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Consultation: We discussed that Thomas Bracket has been designated the legal operator and facility contact of the licensed child care facility. All paperwork has been completed and submitted to make the change in the Regulatory system. The email address for the facility contact has been changed from bertha@stgerardhouse.org to tom.brackett@stgerardhouse.org. We discussed that the TB test or TB screening date of completion would be documented on the staff and training worksheet to know that the staff had TB test results on or before the first day of work. The EPR plan needs an updated Child Care Health Consultant (CCHC). We discussed that the Henderson County CCHC is Patricia Lee, 828.513.0025 or plee.cchc@gmail.com. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 5/22/2025 Number Present: 8 Completed Date: 5/22/2025 Age: From 3 To 6 Total Minutes: 305 Time In: 10:25 AM Time Out: 03:30 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. The program is on a temporary license due to a separation of license from another facility. Bertha Medina, Executive Assistant to CCO, and Ayana Lee, Program Manager, assisted with the visit and were able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/7/24, Daytime Care Only; the next fire inspection is due on or before August 2025 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits. Three (3) children’s files were reviewed. There are twenty-four (24) staff. Eight (8) staff files were reviewed. I observed children during free play and routine care. All children bring snacks and lunch, and have a nutrition opt-out form on file. The facility does not provide transportation, and children do not participate in aquatic activities. The facility must transition to a three-star license or higher to serve children on subsidy vouchers. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. You stated no children will be served through subsidy vouchers and there are no plans to apply for a star rated license. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The last fire drill documented on the emergency log was dated 3/27/25. .0604(t); .0302(d)(5) 825 Before staff members walked children off premises for play or outings, the center did not obtain written permission from the parent of each child. A five year old child was walked off premises without parent permission for the length of time and specific location of the activity for the child. .1005(b)(3) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. An A and D Ointment and Act Bubble Gum toothpaste in space #1, the main classroom for children ages 3 through 6, was located below five feet in children's cubbies. In space #1, four packages of baby wipes with the warning "keep out of reach of children" were located below five feet in a child's cubby. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. An Act Bubble Gum toothpaste did not have a medication authorization form on file for the child. 10A NCAC 09 .0803(4)(6-9) 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 staff hired on 3/15/21 had a medical report dated 3/8/21 that did not specify that the staff was physically and emotionally fit to care for children. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The staff hired on 10/14/18 had an annual staff evaluation on file dated 12/1/22. 10A NCAC 09 .0514(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 6/5/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. Achieving Compliance – rule references are noted in the cited violations *Off Premise Activities - Item #825 We discussed that parent's must know where their child is at all times. An off premise activity is intended to be a special event that takes place away from license space. You stated the child's parents signed a treatment plan to allow the child to go up the stairs at the licensed facility address to transition to a larger setting. We discussed that you do have a restriction on your permit that only allows for the care of children on ground level. The second story of the building does not meet building and fire codes for safe evacuation of children in care at the licensed facility. You stated the transition for the child will pause. For any child participating in an off premise activity, the parent must provide permission for the specific date, time, and place the child will be going and all safety requirements must be met. An off-premise permission form can be located on the Division's website. *Medication Permission - Item #847 We discussed there must be a permission form for any toothpaste for children. You can find the topical permission form on the DCDEE website. *Storage of medication and products labeled keep out of reach of children - Item #841 Any product labeled keep out of reach of children must be stored at least five feet above the floor. Diaper creams must also be kept at least five feet off the floor. 15A NCAC 18A .2820 STORAGE (c) and (d) *Fire Drill - Item #805 You stated a fire drill was completed on 4/30/25 and had not been recorded. Fire drills must be recorded directly after they occur. To achieve compliance, provide a plan on how fire drills will be recorded once they occur. *Staff Files - Items #1032 and We discussed that you could provide the DCDEE staff medical report form for the required information. It is recommended to use the form from the Division's website. A.P. must have an annual evaluation completed. Rated License Consultation It is recommended that you visit www.ncrlap.org for supplemental materials if you choose to apply for a star rated license and prepare for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Consultation: We discussed that Thomas Bracket has been designated the legal operator and facility contact of the licensed child care facility. All paperwork has been completed and submitted to make the change in the Regulatory system. The email address for the facility contact has been changed from bertha@stgerardhouse.org to tom.brackett@stgerardhouse.org. We discussed that the TB test or TB screening date of completion would be documented on the staff and training worksheet to know that the staff had TB test results on or before the first day of work. The EPR plan needs an updated Child Care Health Consultant (CCHC). We discussed that the Henderson County CCHC is Patricia Lee, 828.513.0025 or plee.cchc@gmail.com. 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: St. Gerard House - The Grotto Therapeutic Center Facility ID: 45000436 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 5/22/2025 Number Present: 8 Completed Date: 5/22/2025 Age: From 3 To 6 Total Minutes: 305 Time In: 10:25 AM Time Out: 03:30 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. The program is on a temporary license due to a separation of license from another facility. Bertha Medina, Executive Assistant to CCO, and Ayana Lee, Program Manager, assisted with the visit and were able to answer and ask questions. The Secretary of State website was checked today, and the owner, St. Gerard House, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Approved Fire Inspection – 8/7/24, Daytime Care Only; the next fire inspection is due on or before August 2025 Superior Sanitation Inspection – 4/2/25 with ten (10) Demerits. Three (3) children’s files were reviewed. There are twenty-four (24) staff. Eight (8) staff files were reviewed. I observed children during free play and routine care. All children bring snacks and lunch, and have a nutrition opt-out form on file. The facility does not provide transportation, and children do not participate in aquatic activities. The facility must transition to a three-star license or higher to serve children on subsidy vouchers. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. You stated no children will be served through subsidy vouchers and there are no plans to apply for a star rated license. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The last fire drill documented on the emergency log was dated 3/27/25. .0604(t); .0302(d)(5) 825 Before staff members walked children off premises for play or outings, the center did not obtain written permission from the parent of each child. A five year old child was walked off premises without parent permission for the length of time and specific location of the activity for the child. .1005(b)(3) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. An A and D Ointment and Act Bubble Gum toothpaste in space #1, the main classroom for children ages 3 through 6, was located below five feet in children's cubbies. In space #1, four packages of baby wipes with the warning "keep out of reach of children" were located below five feet in a child's cubby. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. An Act Bubble Gum toothpaste did not have a medication authorization form on file for the child. 10A NCAC 09 .0803(4)(6-9) 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 staff hired on 3/15/21 had a medical report dated 3/8/21 that did not specify that the staff was physically and emotionally fit to care for children. Refer to the staff and training worksheet. 10A NCAC 09 .0701(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The staff hired on 10/14/18 had an annual staff evaluation on file dated 12/1/22. 10A NCAC 09 .0514(f) 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 • Signed statement of compliance I must receive your compliance statement on or before 6/5/25. 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 151 Creekview Rd, Hendersonville, NC 28792 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. Achieving Compliance – rule references are noted in the cited violations *Off Premise Activities - Item #825 We discussed that parent's must know where their child is at all times. An off premise activity is intended to be a special event that takes place away from license space. You stated the child's parents signed a treatment plan to allow the child to go up the stairs at the licensed facility address to transition to a larger setting. We discussed that you do have a restriction on your permit that only allows for the care of children on ground level. The second story of the building does not meet building and fire codes for safe evacuation of children in care at the licensed facility. You stated the transition for the child will pause. For any child participating in an off premise activity, the parent must provide permission for the specific date, time, and place the child will be going and all safety requirements must be met. An off-premise permission form can be located on the Division's website. *Medication Permission - Item #847 We discussed there must be a permission form for any toothpaste for children. You can find the topical permission form on the DCDEE website. *Storage of medication and products labeled keep out of reach of children - Item #841 Any product labeled keep out of reach of children must be stored at least five feet above the floor. Diaper creams must also be kept at least five feet off the floor. 15A NCAC 18A .2820 STORAGE (c) and (d) *Fire Drill - Item #805 You stated a fire drill was completed on 4/30/25 and had not been recorded. Fire drills must be recorded directly after they occur. To achieve compliance, provide a plan on how fire drills will be recorded once they occur. *Staff Files - Items #1032 and We discussed that you could provide the DCDEE staff medical report form for the required information. It is recommended to use the form from the Division's website. A.P. must have an annual evaluation completed. Rated License Consultation It is recommended that you visit www.ncrlap.org for supplemental materials if you choose to apply for a star rated license and prepare for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Consultation: We discussed that Thomas Bracket has been designated the legal operator and facility contact of the licensed child care facility. All paperwork has been completed and submitted to make the change in the Regulatory system. The email address for the facility contact has been changed from bertha@stgerardhouse.org to tom.brackett@stgerardhouse.org. We discussed that the TB test or TB screening date of completion would be documented on the staff and training worksheet to know that the staff had TB test results on or before the first day of work. The EPR plan needs an updated Child Care Health Consultant (CCHC). We discussed that the Henderson County CCHC is Patricia Lee, 828.513.0025 or plee.cchc@gmail.com. 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