Hickory Foundation Ymca Child Development Center

10A NCAC 09 .0608 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/22/2026 Number Present: 68 Completed Date: 1/22/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:05 AM Time Out: 11:30 AM Time In: 12:25 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Cassidy Dale, Administrator, assisted us with today’s visit. I conducted your last annual compliance visit on February 6, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the restrictions, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website on January 20, 2026. Your program’s compliance history was 85% as of January 20, 2026 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 15, 2025 with a Superior classification and four demerits. I verified that you completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicate that the facility’s water is within acceptable limits. I verified that the lead-based paint test results and the asbestos test results both dated January 2, 2026 indicated that this facility has no lead-based paint or asbestos hazards present. The last fire inspection was dated April 1, 2025 and was received in my office on May 1, 2025. I visited each licensed indoor and outdoor space with you today. Children were participating in whole group language activities, transitioning from gym play to the classroom, transitioning from the classroom to outdoor play, playing in activity areas, playing outdoors, attending to personal care routines, eating lunch, napping, eating snack, and departing. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of forty degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at forty-four degrees Fahrenheit in Space 1. Meals and snacks served during today’s visit met the meal pattern requirements. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. The written administrative and personnel policies in the Employee Handbook dated February 2023 were reviewed during the last annual compliance visit on February 6, 2025. The written operational policies and parent participation plan in the Parent Handbook dated December 2025 were reviewed prior to today’s visit with all required components included as required. Today, you stated that your written polices and parent participation plan had not changed since my last review. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. The following steps are how you can begin preparing for the Rated License process: If you choose Pathway 1: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, OR FCCERS-3 books. • Prepare for Environmental Rating Scale (ERS) assessments. o Access resources, trainings, and outreach via ncrlap.org. o Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-old children are enrolled, select and implement an approved curriculum. If you choose Pathway 2: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, May 1, 2026. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • Select and implement a curriculum. (4- and 5-star centers must use an approved curriculum and formative assessment tool for all ages.) • Arrange coaching or training options for administrators and lead teachers. If you choose Pathway 3: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, September 1, 2026. • Ensure all staff have active WORKS accounts. • If you are accredited through NAFCC, NECPA, AMS, or IMC, you may earn a three star rated license with NO Education standards evaluation. • If you are accredited through NAFCC, NECPA, AMS, or IMC and would like to earn a four or five star rated license, the Education standard evaluation will determine the star rating earned. • If you are accredited through NAEYC, NAC, COGNIA, or your facility is Head Start and/or Early Head Start Education, NO Education standards evaluation is needed. • Documentation of accreditation status and Head Start designation must be submitted to process your star rated license. 2. For additional support, I suggested you contact Karla Carpenter, Early Childhood Education Specialist with the Early Childhood Support Team. The following violations were observed and cited during today's visit: Violation Number Comment Rule 847 Parent's medication authorization did not include required information. In Space 2, the permission to administer form for Vaseline had expired on 01/21/2026. In Space 3, the permission to administer form for an over the counter ointment had expired on 01/03/2026. In Space 4, the permission to administer form for one petroleum jelly was missing the instructions for when to apply the ointment. In Space 4, permission to administer one prescribed ointment was documented on the "over the counter topical ointment" form. In Space 5, the permission to administer form for one over the counter allergy medication had expired in 05/2025. 10A NCAC 09 .0803(4)(6-9) 1757 A valid qualification letter was not on file and available to review at the facility. One uncompensated provider who was responsible for supervising a child while delivering services to the child outside of the classroom did not have a CBC qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was dated 09/06/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. .1102(a) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To correct this violation, I suggest you have parents add any missing information to the permission to administer forms or complete a new permission form if the permission expired or was documented on the wrong permission form. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. During today’s visit, I observed the EPR plan dated 09/06/2024. Today, you updated the EPR Plan and printed a new copy for your Ready to Go file which corrected the violation. To maintain compliance with child requirement, I suggest you set a reminder on your electronic calendar to update the EPR Plan annually. 3. Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check (CBC) qualification letter issued from DCDEE on file in their staff records. This includes uncompensated providers such as therapists or counselors who visit your facility and are contracted to work with a child enrolled in your facility. When an uncompensated provider delivers services within the classroom with the teacher present, the uncompensated provider does not have to have a CBC qualification letter from DCDEE because the teacher who has a CBC qualification letter is supervising the child and monitoring the therapy session. However, when the uncompensated provider takes the child out of the classroom to another part of the building and is left alone with the child, then the uncompensated provider has to have CBC qualification letter from DCDEE on file because they are the person responsible for supervising the child. Today, one uncompensated provider who was responsible for supervising a child while delivering services to a child outside of the classroom did not have a CBC qualification letter on file. During today’s visit, you obtained a copy of the uncompensated provider’s CBC qualification letter dated 01/30/2025 and placed it on file. To maintain compliance with this child care requirement, I suggested you provide a three-ring binder divided into sections for each child that receives services. Each child’s section could have a visitor log for the uncompensated provider to sign in and out as they arrive to work to with each child and a sheet protector pocket for each uncompensated provider to add a copy of their CBC qualification letter in each child’s section of the notebook. 4. Per child care rule 10A NCAC 09 .0608(d)(1-4), the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy should be reviewed with all new staff members prior to their caring for children and an acknowledgement statement should be signed and dated by the staff that includes the individual’s name, the date the center’s policy was given and explained to the individual, the individual’s signature, and the date the individual signed the acknowledgment. Today, one staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. You reviewed the policy with the staff member, had them sign the acknowledgement statement and placed the signed acknowledgement statement in the staff member’s file which corrected this violation. To maintain compliance with this child care requirement, I suggested you use the staff acknowledgement page that accompanies the DCDEE sample for a Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy which contains all the required information as it is listed in child care rule and have the substitute staff member sign the acknowledgement statement within the next two weeks. 5. Per child care rule 10A NCAC 09 .1102(a), new employee’s should complete the Health & Safety (H&S) Training requirement within the first year of employment. Health and safety training should be in addition to the new staff orientation requirements. Today, one staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. To correct this violation, the staff member hired on 12/02/2024 should complete all the required health and safety training no later than February 6, 2026. To maintain compliance with this child care requirement, I suggest you require the health and safety training to be completed within the first six weeks of employment in addition to the new staff orientation training. CONSULTATION: 1. Per NC General Statute 110-102, the current version of Summary of North Carolina Child Care Law should be posted in a prominent place in the facility and included in the enrollment packet to be given to parents prior to the child’s first day of attendance. The most current Summary of North Carolina Child Care Law was published in November 2025. Today, I observed the date of the posted Summary of North Carolina Child Care Law was September 2023 and February 2025. Please print the updated version, post it in your lobby, and add it to your new enrollment packets. I also suggest you regularly check the DCDEE website for updated versions and especially when you receive notification of child care or sanitation rule updates. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Child-Care-Rules-Law-and-Public-Information Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the training calendar from the Children’s Resource Center: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 1757, 1824, and 1874 corrected during today’s visit. In the visit summary, I documented the actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 6, 2026. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. We appreciate all you and your staff do to serve the children and families in your community. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/22/2026 Number Present: 68 Completed Date: 1/22/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:05 AM Time Out: 11:30 AM Time In: 12:25 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Cassidy Dale, Administrator, assisted us with today’s visit. I conducted your last annual compliance visit on February 6, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the restrictions, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website on January 20, 2026. Your program’s compliance history was 85% as of January 20, 2026 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 15, 2025 with a Superior classification and four demerits. I verified that you completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicate that the facility’s water is within acceptable limits. I verified that the lead-based paint test results and the asbestos test results both dated January 2, 2026 indicated that this facility has no lead-based paint or asbestos hazards present. The last fire inspection was dated April 1, 2025 and was received in my office on May 1, 2025. I visited each licensed indoor and outdoor space with you today. Children were participating in whole group language activities, transitioning from gym play to the classroom, transitioning from the classroom to outdoor play, playing in activity areas, playing outdoors, attending to personal care routines, eating lunch, napping, eating snack, and departing. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of forty degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at forty-four degrees Fahrenheit in Space 1. Meals and snacks served during today’s visit met the meal pattern requirements. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. The written administrative and personnel policies in the Employee Handbook dated February 2023 were reviewed during the last annual compliance visit on February 6, 2025. The written operational policies and parent participation plan in the Parent Handbook dated December 2025 were reviewed prior to today’s visit with all required components included as required. Today, you stated that your written polices and parent participation plan had not changed since my last review. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. The following steps are how you can begin preparing for the Rated License process: If you choose Pathway 1: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, OR FCCERS-3 books. • Prepare for Environmental Rating Scale (ERS) assessments. o Access resources, trainings, and outreach via ncrlap.org. o Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-old children are enrolled, select and implement an approved curriculum. If you choose Pathway 2: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, May 1, 2026. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • Select and implement a curriculum. (4- and 5-star centers must use an approved curriculum and formative assessment tool for all ages.) • Arrange coaching or training options for administrators and lead teachers. If you choose Pathway 3: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, September 1, 2026. • Ensure all staff have active WORKS accounts. • If you are accredited through NAFCC, NECPA, AMS, or IMC, you may earn a three star rated license with NO Education standards evaluation. • If you are accredited through NAFCC, NECPA, AMS, or IMC and would like to earn a four or five star rated license, the Education standard evaluation will determine the star rating earned. • If you are accredited through NAEYC, NAC, COGNIA, or your facility is Head Start and/or Early Head Start Education, NO Education standards evaluation is needed. • Documentation of accreditation status and Head Start designation must be submitted to process your star rated license. 2. For additional support, I suggested you contact Karla Carpenter, Early Childhood Education Specialist with the Early Childhood Support Team. The following violations were observed and cited during today's visit: Violation Number Comment Rule 847 Parent's medication authorization did not include required information. In Space 2, the permission to administer form for Vaseline had expired on 01/21/2026. In Space 3, the permission to administer form for an over the counter ointment had expired on 01/03/2026. In Space 4, the permission to administer form for one petroleum jelly was missing the instructions for when to apply the ointment. In Space 4, permission to administer one prescribed ointment was documented on the "over the counter topical ointment" form. In Space 5, the permission to administer form for one over the counter allergy medication had expired in 05/2025. 10A NCAC 09 .0803(4)(6-9) 1757 A valid qualification letter was not on file and available to review at the facility. One uncompensated provider who was responsible for supervising a child while delivering services to the child outside of the classroom did not have a CBC qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was dated 09/06/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. .1102(a) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To correct this violation, I suggest you have parents add any missing information to the permission to administer forms or complete a new permission form if the permission expired or was documented on the wrong permission form. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. During today’s visit, I observed the EPR plan dated 09/06/2024. Today, you updated the EPR Plan and printed a new copy for your Ready to Go file which corrected the violation. To maintain compliance with child requirement, I suggest you set a reminder on your electronic calendar to update the EPR Plan annually. 3. Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check (CBC) qualification letter issued from DCDEE on file in their staff records. This includes uncompensated providers such as therapists or counselors who visit your facility and are contracted to work with a child enrolled in your facility. When an uncompensated provider delivers services within the classroom with the teacher present, the uncompensated provider does not have to have a CBC qualification letter from DCDEE because the teacher who has a CBC qualification letter is supervising the child and monitoring the therapy session. However, when the uncompensated provider takes the child out of the classroom to another part of the building and is left alone with the child, then the uncompensated provider has to have CBC qualification letter from DCDEE on file because they are the person responsible for supervising the child. Today, one uncompensated provider who was responsible for supervising a child while delivering services to a child outside of the classroom did not have a CBC qualification letter on file. During today’s visit, you obtained a copy of the uncompensated provider’s CBC qualification letter dated 01/30/2025 and placed it on file. To maintain compliance with this child care requirement, I suggested you provide a three-ring binder divided into sections for each child that receives services. Each child’s section could have a visitor log for the uncompensated provider to sign in and out as they arrive to work to with each child and a sheet protector pocket for each uncompensated provider to add a copy of their CBC qualification letter in each child’s section of the notebook. 4. Per child care rule 10A NCAC 09 .0608(d)(1-4), the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy should be reviewed with all new staff members prior to their caring for children and an acknowledgement statement should be signed and dated by the staff that includes the individual’s name, the date the center’s policy was given and explained to the individual, the individual’s signature, and the date the individual signed the acknowledgment. Today, one staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. You reviewed the policy with the staff member, had them sign the acknowledgement statement and placed the signed acknowledgement statement in the staff member’s file which corrected this violation. To maintain compliance with this child care requirement, I suggested you use the staff acknowledgement page that accompanies the DCDEE sample for a Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy which contains all the required information as it is listed in child care rule and have the substitute staff member sign the acknowledgement statement within the next two weeks. 5. Per child care rule 10A NCAC 09 .1102(a), new employee’s should complete the Health & Safety (H&S) Training requirement within the first year of employment. Health and safety training should be in addition to the new staff orientation requirements. Today, one staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. To correct this violation, the staff member hired on 12/02/2024 should complete all the required health and safety training no later than February 6, 2026. To maintain compliance with this child care requirement, I suggest you require the health and safety training to be completed within the first six weeks of employment in addition to the new staff orientation training. CONSULTATION: 1. Per NC General Statute 110-102, the current version of Summary of North Carolina Child Care Law should be posted in a prominent place in the facility and included in the enrollment packet to be given to parents prior to the child’s first day of attendance. The most current Summary of North Carolina Child Care Law was published in November 2025. Today, I observed the date of the posted Summary of North Carolina Child Care Law was September 2023 and February 2025. Please print the updated version, post it in your lobby, and add it to your new enrollment packets. I also suggest you regularly check the DCDEE website for updated versions and especially when you receive notification of child care or sanitation rule updates. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Child-Care-Rules-Law-and-Public-Information Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the training calendar from the Children’s Resource Center: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 1757, 1824, and 1874 corrected during today’s visit. In the visit summary, I documented the actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 6, 2026. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. We appreciate all you and your staff do to serve the children and families in your community. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/22/2026 Number Present: 68 Completed Date: 1/22/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:05 AM Time Out: 11:30 AM Time In: 12:25 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Cassidy Dale, Administrator, assisted us with today’s visit. I conducted your last annual compliance visit on February 6, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the restrictions, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website on January 20, 2026. Your program’s compliance history was 85% as of January 20, 2026 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 15, 2025 with a Superior classification and four demerits. I verified that you completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicate that the facility’s water is within acceptable limits. I verified that the lead-based paint test results and the asbestos test results both dated January 2, 2026 indicated that this facility has no lead-based paint or asbestos hazards present. The last fire inspection was dated April 1, 2025 and was received in my office on May 1, 2025. I visited each licensed indoor and outdoor space with you today. Children were participating in whole group language activities, transitioning from gym play to the classroom, transitioning from the classroom to outdoor play, playing in activity areas, playing outdoors, attending to personal care routines, eating lunch, napping, eating snack, and departing. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of forty degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at forty-four degrees Fahrenheit in Space 1. Meals and snacks served during today’s visit met the meal pattern requirements. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. The written administrative and personnel policies in the Employee Handbook dated February 2023 were reviewed during the last annual compliance visit on February 6, 2025. The written operational policies and parent participation plan in the Parent Handbook dated December 2025 were reviewed prior to today’s visit with all required components included as required. Today, you stated that your written polices and parent participation plan had not changed since my last review. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. The following steps are how you can begin preparing for the Rated License process: If you choose Pathway 1: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, OR FCCERS-3 books. • Prepare for Environmental Rating Scale (ERS) assessments. o Access resources, trainings, and outreach via ncrlap.org. o Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-old children are enrolled, select and implement an approved curriculum. If you choose Pathway 2: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, May 1, 2026. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • Select and implement a curriculum. (4- and 5-star centers must use an approved curriculum and formative assessment tool for all ages.) • Arrange coaching or training options for administrators and lead teachers. If you choose Pathway 3: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, September 1, 2026. • Ensure all staff have active WORKS accounts. • If you are accredited through NAFCC, NECPA, AMS, or IMC, you may earn a three star rated license with NO Education standards evaluation. • If you are accredited through NAFCC, NECPA, AMS, or IMC and would like to earn a four or five star rated license, the Education standard evaluation will determine the star rating earned. • If you are accredited through NAEYC, NAC, COGNIA, or your facility is Head Start and/or Early Head Start Education, NO Education standards evaluation is needed. • Documentation of accreditation status and Head Start designation must be submitted to process your star rated license. 2. For additional support, I suggested you contact Karla Carpenter, Early Childhood Education Specialist with the Early Childhood Support Team. The following violations were observed and cited during today's visit: Violation Number Comment Rule 847 Parent's medication authorization did not include required information. In Space 2, the permission to administer form for Vaseline had expired on 01/21/2026. In Space 3, the permission to administer form for an over the counter ointment had expired on 01/03/2026. In Space 4, the permission to administer form for one petroleum jelly was missing the instructions for when to apply the ointment. In Space 4, permission to administer one prescribed ointment was documented on the "over the counter topical ointment" form. In Space 5, the permission to administer form for one over the counter allergy medication had expired in 05/2025. 10A NCAC 09 .0803(4)(6-9) 1757 A valid qualification letter was not on file and available to review at the facility. One uncompensated provider who was responsible for supervising a child while delivering services to the child outside of the classroom did not have a CBC qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was dated 09/06/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. .1102(a) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To correct this violation, I suggest you have parents add any missing information to the permission to administer forms or complete a new permission form if the permission expired or was documented on the wrong permission form. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. During today’s visit, I observed the EPR plan dated 09/06/2024. Today, you updated the EPR Plan and printed a new copy for your Ready to Go file which corrected the violation. To maintain compliance with child requirement, I suggest you set a reminder on your electronic calendar to update the EPR Plan annually. 3. Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check (CBC) qualification letter issued from DCDEE on file in their staff records. This includes uncompensated providers such as therapists or counselors who visit your facility and are contracted to work with a child enrolled in your facility. When an uncompensated provider delivers services within the classroom with the teacher present, the uncompensated provider does not have to have a CBC qualification letter from DCDEE because the teacher who has a CBC qualification letter is supervising the child and monitoring the therapy session. However, when the uncompensated provider takes the child out of the classroom to another part of the building and is left alone with the child, then the uncompensated provider has to have CBC qualification letter from DCDEE on file because they are the person responsible for supervising the child. Today, one uncompensated provider who was responsible for supervising a child while delivering services to a child outside of the classroom did not have a CBC qualification letter on file. During today’s visit, you obtained a copy of the uncompensated provider’s CBC qualification letter dated 01/30/2025 and placed it on file. To maintain compliance with this child care requirement, I suggested you provide a three-ring binder divided into sections for each child that receives services. Each child’s section could have a visitor log for the uncompensated provider to sign in and out as they arrive to work to with each child and a sheet protector pocket for each uncompensated provider to add a copy of their CBC qualification letter in each child’s section of the notebook. 4. Per child care rule 10A NCAC 09 .0608(d)(1-4), the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy should be reviewed with all new staff members prior to their caring for children and an acknowledgement statement should be signed and dated by the staff that includes the individual’s name, the date the center’s policy was given and explained to the individual, the individual’s signature, and the date the individual signed the acknowledgment. Today, one staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. You reviewed the policy with the staff member, had them sign the acknowledgement statement and placed the signed acknowledgement statement in the staff member’s file which corrected this violation. To maintain compliance with this child care requirement, I suggested you use the staff acknowledgement page that accompanies the DCDEE sample for a Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy which contains all the required information as it is listed in child care rule and have the substitute staff member sign the acknowledgement statement within the next two weeks. 5. Per child care rule 10A NCAC 09 .1102(a), new employee’s should complete the Health & Safety (H&S) Training requirement within the first year of employment. Health and safety training should be in addition to the new staff orientation requirements. Today, one staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. To correct this violation, the staff member hired on 12/02/2024 should complete all the required health and safety training no later than February 6, 2026. To maintain compliance with this child care requirement, I suggest you require the health and safety training to be completed within the first six weeks of employment in addition to the new staff orientation training. CONSULTATION: 1. Per NC General Statute 110-102, the current version of Summary of North Carolina Child Care Law should be posted in a prominent place in the facility and included in the enrollment packet to be given to parents prior to the child’s first day of attendance. The most current Summary of North Carolina Child Care Law was published in November 2025. Today, I observed the date of the posted Summary of North Carolina Child Care Law was September 2023 and February 2025. Please print the updated version, post it in your lobby, and add it to your new enrollment packets. I also suggest you regularly check the DCDEE website for updated versions and especially when you receive notification of child care or sanitation rule updates. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Child-Care-Rules-Law-and-Public-Information Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the training calendar from the Children’s Resource Center: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 1757, 1824, and 1874 corrected during today’s visit. In the visit summary, I documented the actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 6, 2026. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. We appreciate all you and your staff do to serve the children and families in your community. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2703 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/22/2026 Number Present: 68 Completed Date: 1/22/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:05 AM Time Out: 11:30 AM Time In: 12:25 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Cassidy Dale, Administrator, assisted us with today’s visit. I conducted your last annual compliance visit on February 6, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the restrictions, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website on January 20, 2026. Your program’s compliance history was 85% as of January 20, 2026 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 15, 2025 with a Superior classification and four demerits. I verified that you completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicate that the facility’s water is within acceptable limits. I verified that the lead-based paint test results and the asbestos test results both dated January 2, 2026 indicated that this facility has no lead-based paint or asbestos hazards present. The last fire inspection was dated April 1, 2025 and was received in my office on May 1, 2025. I visited each licensed indoor and outdoor space with you today. Children were participating in whole group language activities, transitioning from gym play to the classroom, transitioning from the classroom to outdoor play, playing in activity areas, playing outdoors, attending to personal care routines, eating lunch, napping, eating snack, and departing. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of forty degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at forty-four degrees Fahrenheit in Space 1. Meals and snacks served during today’s visit met the meal pattern requirements. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. The written administrative and personnel policies in the Employee Handbook dated February 2023 were reviewed during the last annual compliance visit on February 6, 2025. The written operational policies and parent participation plan in the Parent Handbook dated December 2025 were reviewed prior to today’s visit with all required components included as required. Today, you stated that your written polices and parent participation plan had not changed since my last review. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. The following steps are how you can begin preparing for the Rated License process: If you choose Pathway 1: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, OR FCCERS-3 books. • Prepare for Environmental Rating Scale (ERS) assessments. o Access resources, trainings, and outreach via ncrlap.org. o Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-old children are enrolled, select and implement an approved curriculum. If you choose Pathway 2: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, May 1, 2026. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • Select and implement a curriculum. (4- and 5-star centers must use an approved curriculum and formative assessment tool for all ages.) • Arrange coaching or training options for administrators and lead teachers. If you choose Pathway 3: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, September 1, 2026. • Ensure all staff have active WORKS accounts. • If you are accredited through NAFCC, NECPA, AMS, or IMC, you may earn a three star rated license with NO Education standards evaluation. • If you are accredited through NAFCC, NECPA, AMS, or IMC and would like to earn a four or five star rated license, the Education standard evaluation will determine the star rating earned. • If you are accredited through NAEYC, NAC, COGNIA, or your facility is Head Start and/or Early Head Start Education, NO Education standards evaluation is needed. • Documentation of accreditation status and Head Start designation must be submitted to process your star rated license. 2. For additional support, I suggested you contact Karla Carpenter, Early Childhood Education Specialist with the Early Childhood Support Team. The following violations were observed and cited during today's visit: Violation Number Comment Rule 847 Parent's medication authorization did not include required information. In Space 2, the permission to administer form for Vaseline had expired on 01/21/2026. In Space 3, the permission to administer form for an over the counter ointment had expired on 01/03/2026. In Space 4, the permission to administer form for one petroleum jelly was missing the instructions for when to apply the ointment. In Space 4, permission to administer one prescribed ointment was documented on the "over the counter topical ointment" form. In Space 5, the permission to administer form for one over the counter allergy medication had expired in 05/2025. 10A NCAC 09 .0803(4)(6-9) 1757 A valid qualification letter was not on file and available to review at the facility. One uncompensated provider who was responsible for supervising a child while delivering services to the child outside of the classroom did not have a CBC qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was dated 09/06/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. .1102(a) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To correct this violation, I suggest you have parents add any missing information to the permission to administer forms or complete a new permission form if the permission expired or was documented on the wrong permission form. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. During today’s visit, I observed the EPR plan dated 09/06/2024. Today, you updated the EPR Plan and printed a new copy for your Ready to Go file which corrected the violation. To maintain compliance with child requirement, I suggest you set a reminder on your electronic calendar to update the EPR Plan annually. 3. Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check (CBC) qualification letter issued from DCDEE on file in their staff records. This includes uncompensated providers such as therapists or counselors who visit your facility and are contracted to work with a child enrolled in your facility. When an uncompensated provider delivers services within the classroom with the teacher present, the uncompensated provider does not have to have a CBC qualification letter from DCDEE because the teacher who has a CBC qualification letter is supervising the child and monitoring the therapy session. However, when the uncompensated provider takes the child out of the classroom to another part of the building and is left alone with the child, then the uncompensated provider has to have CBC qualification letter from DCDEE on file because they are the person responsible for supervising the child. Today, one uncompensated provider who was responsible for supervising a child while delivering services to a child outside of the classroom did not have a CBC qualification letter on file. During today’s visit, you obtained a copy of the uncompensated provider’s CBC qualification letter dated 01/30/2025 and placed it on file. To maintain compliance with this child care requirement, I suggested you provide a three-ring binder divided into sections for each child that receives services. Each child’s section could have a visitor log for the uncompensated provider to sign in and out as they arrive to work to with each child and a sheet protector pocket for each uncompensated provider to add a copy of their CBC qualification letter in each child’s section of the notebook. 4. Per child care rule 10A NCAC 09 .0608(d)(1-4), the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy should be reviewed with all new staff members prior to their caring for children and an acknowledgement statement should be signed and dated by the staff that includes the individual’s name, the date the center’s policy was given and explained to the individual, the individual’s signature, and the date the individual signed the acknowledgment. Today, one staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. You reviewed the policy with the staff member, had them sign the acknowledgement statement and placed the signed acknowledgement statement in the staff member’s file which corrected this violation. To maintain compliance with this child care requirement, I suggested you use the staff acknowledgement page that accompanies the DCDEE sample for a Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy which contains all the required information as it is listed in child care rule and have the substitute staff member sign the acknowledgement statement within the next two weeks. 5. Per child care rule 10A NCAC 09 .1102(a), new employee’s should complete the Health & Safety (H&S) Training requirement within the first year of employment. Health and safety training should be in addition to the new staff orientation requirements. Today, one staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. To correct this violation, the staff member hired on 12/02/2024 should complete all the required health and safety training no later than February 6, 2026. To maintain compliance with this child care requirement, I suggest you require the health and safety training to be completed within the first six weeks of employment in addition to the new staff orientation training. CONSULTATION: 1. Per NC General Statute 110-102, the current version of Summary of North Carolina Child Care Law should be posted in a prominent place in the facility and included in the enrollment packet to be given to parents prior to the child’s first day of attendance. The most current Summary of North Carolina Child Care Law was published in November 2025. Today, I observed the date of the posted Summary of North Carolina Child Care Law was September 2023 and February 2025. Please print the updated version, post it in your lobby, and add it to your new enrollment packets. I also suggest you regularly check the DCDEE website for updated versions and especially when you receive notification of child care or sanitation rule updates. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Child-Care-Rules-Law-and-Public-Information Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the training calendar from the Children’s Resource Center: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 1757, 1824, and 1874 corrected during today’s visit. In the visit summary, I documented the actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 6, 2026. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. We appreciate all you and your staff do to serve the children and families in your community. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/22/2026 Number Present: 68 Completed Date: 1/22/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:05 AM Time Out: 11:30 AM Time In: 12:25 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Cassidy Dale, Administrator, assisted us with today’s visit. I conducted your last annual compliance visit on February 6, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the restrictions, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website on January 20, 2026. Your program’s compliance history was 85% as of January 20, 2026 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 15, 2025 with a Superior classification and four demerits. I verified that you completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicate that the facility’s water is within acceptable limits. I verified that the lead-based paint test results and the asbestos test results both dated January 2, 2026 indicated that this facility has no lead-based paint or asbestos hazards present. The last fire inspection was dated April 1, 2025 and was received in my office on May 1, 2025. I visited each licensed indoor and outdoor space with you today. Children were participating in whole group language activities, transitioning from gym play to the classroom, transitioning from the classroom to outdoor play, playing in activity areas, playing outdoors, attending to personal care routines, eating lunch, napping, eating snack, and departing. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of forty degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at forty-four degrees Fahrenheit in Space 1. Meals and snacks served during today’s visit met the meal pattern requirements. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. The written administrative and personnel policies in the Employee Handbook dated February 2023 were reviewed during the last annual compliance visit on February 6, 2025. The written operational policies and parent participation plan in the Parent Handbook dated December 2025 were reviewed prior to today’s visit with all required components included as required. Today, you stated that your written polices and parent participation plan had not changed since my last review. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. The following steps are how you can begin preparing for the Rated License process: If you choose Pathway 1: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, OR FCCERS-3 books. • Prepare for Environmental Rating Scale (ERS) assessments. o Access resources, trainings, and outreach via ncrlap.org. o Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-old children are enrolled, select and implement an approved curriculum. If you choose Pathway 2: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, May 1, 2026. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • Select and implement a curriculum. (4- and 5-star centers must use an approved curriculum and formative assessment tool for all ages.) • Arrange coaching or training options for administrators and lead teachers. If you choose Pathway 3: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, September 1, 2026. • Ensure all staff have active WORKS accounts. • If you are accredited through NAFCC, NECPA, AMS, or IMC, you may earn a three star rated license with NO Education standards evaluation. • If you are accredited through NAFCC, NECPA, AMS, or IMC and would like to earn a four or five star rated license, the Education standard evaluation will determine the star rating earned. • If you are accredited through NAEYC, NAC, COGNIA, or your facility is Head Start and/or Early Head Start Education, NO Education standards evaluation is needed. • Documentation of accreditation status and Head Start designation must be submitted to process your star rated license. 2. For additional support, I suggested you contact Karla Carpenter, Early Childhood Education Specialist with the Early Childhood Support Team. The following violations were observed and cited during today's visit: Violation Number Comment Rule 847 Parent's medication authorization did not include required information. In Space 2, the permission to administer form for Vaseline had expired on 01/21/2026. In Space 3, the permission to administer form for an over the counter ointment had expired on 01/03/2026. In Space 4, the permission to administer form for one petroleum jelly was missing the instructions for when to apply the ointment. In Space 4, permission to administer one prescribed ointment was documented on the "over the counter topical ointment" form. In Space 5, the permission to administer form for one over the counter allergy medication had expired in 05/2025. 10A NCAC 09 .0803(4)(6-9) 1757 A valid qualification letter was not on file and available to review at the facility. One uncompensated provider who was responsible for supervising a child while delivering services to the child outside of the classroom did not have a CBC qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was dated 09/06/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. .1102(a) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To correct this violation, I suggest you have parents add any missing information to the permission to administer forms or complete a new permission form if the permission expired or was documented on the wrong permission form. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. During today’s visit, I observed the EPR plan dated 09/06/2024. Today, you updated the EPR Plan and printed a new copy for your Ready to Go file which corrected the violation. To maintain compliance with child requirement, I suggest you set a reminder on your electronic calendar to update the EPR Plan annually. 3. Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check (CBC) qualification letter issued from DCDEE on file in their staff records. This includes uncompensated providers such as therapists or counselors who visit your facility and are contracted to work with a child enrolled in your facility. When an uncompensated provider delivers services within the classroom with the teacher present, the uncompensated provider does not have to have a CBC qualification letter from DCDEE because the teacher who has a CBC qualification letter is supervising the child and monitoring the therapy session. However, when the uncompensated provider takes the child out of the classroom to another part of the building and is left alone with the child, then the uncompensated provider has to have CBC qualification letter from DCDEE on file because they are the person responsible for supervising the child. Today, one uncompensated provider who was responsible for supervising a child while delivering services to a child outside of the classroom did not have a CBC qualification letter on file. During today’s visit, you obtained a copy of the uncompensated provider’s CBC qualification letter dated 01/30/2025 and placed it on file. To maintain compliance with this child care requirement, I suggested you provide a three-ring binder divided into sections for each child that receives services. Each child’s section could have a visitor log for the uncompensated provider to sign in and out as they arrive to work to with each child and a sheet protector pocket for each uncompensated provider to add a copy of their CBC qualification letter in each child’s section of the notebook. 4. Per child care rule 10A NCAC 09 .0608(d)(1-4), the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy should be reviewed with all new staff members prior to their caring for children and an acknowledgement statement should be signed and dated by the staff that includes the individual’s name, the date the center’s policy was given and explained to the individual, the individual’s signature, and the date the individual signed the acknowledgment. Today, one staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. You reviewed the policy with the staff member, had them sign the acknowledgement statement and placed the signed acknowledgement statement in the staff member’s file which corrected this violation. To maintain compliance with this child care requirement, I suggested you use the staff acknowledgement page that accompanies the DCDEE sample for a Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy which contains all the required information as it is listed in child care rule and have the substitute staff member sign the acknowledgement statement within the next two weeks. 5. Per child care rule 10A NCAC 09 .1102(a), new employee’s should complete the Health & Safety (H&S) Training requirement within the first year of employment. Health and safety training should be in addition to the new staff orientation requirements. Today, one staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. To correct this violation, the staff member hired on 12/02/2024 should complete all the required health and safety training no later than February 6, 2026. To maintain compliance with this child care requirement, I suggest you require the health and safety training to be completed within the first six weeks of employment in addition to the new staff orientation training. CONSULTATION: 1. Per NC General Statute 110-102, the current version of Summary of North Carolina Child Care Law should be posted in a prominent place in the facility and included in the enrollment packet to be given to parents prior to the child’s first day of attendance. The most current Summary of North Carolina Child Care Law was published in November 2025. Today, I observed the date of the posted Summary of North Carolina Child Care Law was September 2023 and February 2025. Please print the updated version, post it in your lobby, and add it to your new enrollment packets. I also suggest you regularly check the DCDEE website for updated versions and especially when you receive notification of child care or sanitation rule updates. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Child-Care-Rules-Law-and-Public-Information Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the training calendar from the Children’s Resource Center: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 1757, 1824, and 1874 corrected during today’s visit. In the visit summary, I documented the actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 6, 2026. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. We appreciate all you and your staff do to serve the children and families in your community. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0607 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 1/22/2026 Number Present: 68 Completed Date: 1/22/2026 Age: From 0 To 5 Total Minutes: 420 Time In: 09:05 AM Time Out: 11:30 AM Time In: 12:25 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Cassidy Dale, Administrator, assisted us with today’s visit. I conducted your last annual compliance visit on February 6, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the restrictions, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website on January 20, 2026. Your program’s compliance history was 85% as of January 20, 2026 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 15, 2025 with a Superior classification and four demerits. I verified that you completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicate that the facility’s water is within acceptable limits. I verified that the lead-based paint test results and the asbestos test results both dated January 2, 2026 indicated that this facility has no lead-based paint or asbestos hazards present. The last fire inspection was dated April 1, 2025 and was received in my office on May 1, 2025. I visited each licensed indoor and outdoor space with you today. Children were participating in whole group language activities, transitioning from gym play to the classroom, transitioning from the classroom to outdoor play, playing in activity areas, playing outdoors, attending to personal care routines, eating lunch, napping, eating snack, and departing. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of forty degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at forty-four degrees Fahrenheit in Space 1. Meals and snacks served during today’s visit met the meal pattern requirements. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. The written administrative and personnel policies in the Employee Handbook dated February 2023 were reviewed during the last annual compliance visit on February 6, 2025. The written operational policies and parent participation plan in the Parent Handbook dated December 2025 were reviewed prior to today’s visit with all required components included as required. Today, you stated that your written polices and parent participation plan had not changed since my last review. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. The following steps are how you can begin preparing for the Rated License process: If you choose Pathway 1: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, April 1, 2026 or as soon as the three-month self-study is completed. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, OR FCCERS-3 books. • Prepare for Environmental Rating Scale (ERS) assessments. o Access resources, trainings, and outreach via ncrlap.org. o Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-old children are enrolled, select and implement an approved curriculum. If you choose Pathway 2: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, May 1, 2026. • Confirm all staff have active WORKS accounts. • Confirm all staff have WORKS evaluate any additional education. • Confirm all staff have listed in WORKS all the facilities and hire dates for which they have worked. • Complete the QRIS Staff Information and Education Worksheet electronically. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • Select and implement a curriculum. (4- and 5-star centers must use an approved curriculum and formative assessment tool for all ages.) • Arrange coaching or training options for administrators and lead teachers. If you choose Pathway 3: • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, September 1, 2026. • Ensure all staff have active WORKS accounts. • If you are accredited through NAFCC, NECPA, AMS, or IMC, you may earn a three star rated license with NO Education standards evaluation. • If you are accredited through NAFCC, NECPA, AMS, or IMC and would like to earn a four or five star rated license, the Education standard evaluation will determine the star rating earned. • If you are accredited through NAEYC, NAC, COGNIA, or your facility is Head Start and/or Early Head Start Education, NO Education standards evaluation is needed. • Documentation of accreditation status and Head Start designation must be submitted to process your star rated license. 2. For additional support, I suggested you contact Karla Carpenter, Early Childhood Education Specialist with the Early Childhood Support Team. The following violations were observed and cited during today's visit: Violation Number Comment Rule 847 Parent's medication authorization did not include required information. In Space 2, the permission to administer form for Vaseline had expired on 01/21/2026. In Space 3, the permission to administer form for an over the counter ointment had expired on 01/03/2026. In Space 4, the permission to administer form for one petroleum jelly was missing the instructions for when to apply the ointment. In Space 4, permission to administer one prescribed ointment was documented on the "over the counter topical ointment" form. In Space 5, the permission to administer form for one over the counter allergy medication had expired in 05/2025. 10A NCAC 09 .0803(4)(6-9) 1757 A valid qualification letter was not on file and available to review at the facility. One uncompensated provider who was responsible for supervising a child while delivering services to the child outside of the classroom did not have a CBC qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was dated 09/06/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. .1102(a) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To correct this violation, I suggest you have parents add any missing information to the permission to administer forms or complete a new permission form if the permission expired or was documented on the wrong permission form. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. During today’s visit, I observed the EPR plan dated 09/06/2024. Today, you updated the EPR Plan and printed a new copy for your Ready to Go file which corrected the violation. To maintain compliance with child requirement, I suggest you set a reminder on your electronic calendar to update the EPR Plan annually. 3. Per G.S. 110-90.2(b) & (d) & 10A NCAC 09 .2703(e), each child care provider should have a valid Criminal Background Check (CBC) qualification letter issued from DCDEE on file in their staff records. This includes uncompensated providers such as therapists or counselors who visit your facility and are contracted to work with a child enrolled in your facility. When an uncompensated provider delivers services within the classroom with the teacher present, the uncompensated provider does not have to have a CBC qualification letter from DCDEE because the teacher who has a CBC qualification letter is supervising the child and monitoring the therapy session. However, when the uncompensated provider takes the child out of the classroom to another part of the building and is left alone with the child, then the uncompensated provider has to have CBC qualification letter from DCDEE on file because they are the person responsible for supervising the child. Today, one uncompensated provider who was responsible for supervising a child while delivering services to a child outside of the classroom did not have a CBC qualification letter on file. During today’s visit, you obtained a copy of the uncompensated provider’s CBC qualification letter dated 01/30/2025 and placed it on file. To maintain compliance with this child care requirement, I suggested you provide a three-ring binder divided into sections for each child that receives services. Each child’s section could have a visitor log for the uncompensated provider to sign in and out as they arrive to work to with each child and a sheet protector pocket for each uncompensated provider to add a copy of their CBC qualification letter in each child’s section of the notebook. 4. Per child care rule 10A NCAC 09 .0608(d)(1-4), the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy should be reviewed with all new staff members prior to their caring for children and an acknowledgement statement should be signed and dated by the staff that includes the individual’s name, the date the center’s policy was given and explained to the individual, the individual’s signature, and the date the individual signed the acknowledgment. Today, one staff member with a date of employment of 08/19/2025 did not have a signed acknowledgement statement on file documenting that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy had been reviewed with them prior to their caring for children. You reviewed the policy with the staff member, had them sign the acknowledgement statement and placed the signed acknowledgement statement in the staff member’s file which corrected this violation. To maintain compliance with this child care requirement, I suggested you use the staff acknowledgement page that accompanies the DCDEE sample for a Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy which contains all the required information as it is listed in child care rule and have the substitute staff member sign the acknowledgement statement within the next two weeks. 5. Per child care rule 10A NCAC 09 .1102(a), new employee’s should complete the Health & Safety (H&S) Training requirement within the first year of employment. Health and safety training should be in addition to the new staff orientation requirements. Today, one staff member with a date of employment of 10/08/2024 completed their health and safety training requirements by 10/20/2025. One staff member with a date of employment of 12/02/2024 had health and safety training certificates on file dated 02/2023 which were more than twelve months old. To correct this violation, the staff member hired on 12/02/2024 should complete all the required health and safety training no later than February 6, 2026. To maintain compliance with this child care requirement, I suggest you require the health and safety training to be completed within the first six weeks of employment in addition to the new staff orientation training. CONSULTATION: 1. Per NC General Statute 110-102, the current version of Summary of North Carolina Child Care Law should be posted in a prominent place in the facility and included in the enrollment packet to be given to parents prior to the child’s first day of attendance. The most current Summary of North Carolina Child Care Law was published in November 2025. Today, I observed the date of the posted Summary of North Carolina Child Care Law was September 2023 and February 2025. Please print the updated version, post it in your lobby, and add it to your new enrollment packets. I also suggest you regularly check the DCDEE website for updated versions and especially when you receive notification of child care or sanitation rule updates. 2. When and if you update your fire evacuation route, shelter-in-place, and/or lock-down drill plan, you need to have the fire department approve the your plan first BEFORE you put it in your EPR plan as an update. 3. We encourage you to visit the QRIS Modernization page on the DCDEE website at this link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization to learn more now. 4. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. 5. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Child-Care-Rules-Law-and-Public-Information Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development QRIS Modernization Plan resources: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Healthy Social Behaviors: https://www.childcarerrnc.org/special-projects/healthy-social-behaviors/. Healthy Social Behaviors Helpline: Call at 1-704-376-6697 or toll free at 1-888-600-1685 Option 1 or email at sbrawley@childcareresourcesinc.org or jbyrd@childcareresources.org. Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New 6. Here is the link to the training calendar from the Children’s Resource Center: https://childrensresourcecenter.org/training-calendar/. 7. If you would like an electronic link to any of the links shared above, please send me an email requesting the links that you wish to receive, and I will be glad to send the hyperlinks to you by email. COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 1757, 1824, and 1874 corrected during today’s visit. In the visit summary, I documented the actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 6, 2026. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. We appreciate all you and your staff do to serve the children and families in your community. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 0425-278L Visit Date: 5/7/2025 Number Present: 65 Completed Date: 5/7/2025 Age: From 0 To 5 Total Minutes: 348 Time In: 10:03 AM Time Out: 01:15 PM Time In: 02:39 PM Time Out: 05:15 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to gather information related to allegations of violations of child care requirements. You, Susan Rowe, Assistant Director, assisted me with the visit. Your compliance history prior to today’s visit was 87% prior to today’s visit. You stated you had seventy children enrolled ranging from infant to five-years of age with sixty-five children ranging from infant to five-years of age present today. According to the report, there are allegations of violations of child care requirements regarding activities/schedules/plans, nutrition, and supervision. I visited the room for infant age children to investigate the allegation of child care requirements regarding activities/schedules/plans. Seven infant age children (Child 1 – 7) were enrolled and present in the classroom today with two teachers (Teacher A and Teacher B) supervising the group. At approximately 10:05am, I entered the classroom for infant age children. I observed Child 1 – 5 sleeping in their cribs. Teacher A was bottle feeding Child 6 while holding and rocking the child. Teacher B was bottle feeding Child 7 while holding and rocking the child. At 10:13am, Child 6 completed their bottle. Child 6 had fallen asleep while taking their bottle and Teacher A laid the sleeping Child 6 down in their crib. At 10:25am, Child 7 completed their bottle and Teacher B transferred the child to their crib. Child 7 was observed awake upon being laid in their crib. Child 7 was asleep at 10:29am. Teacher B retrieved a bottle from the refrigerator and placed it in the warmer. At 10:29, Child 5 awoke from their nap and began to whine. Teacher B picked up Child 5 from the crib and comforted the child while carrying Child 5 to the diaper changing table where the child’s diaper was changed. Teacher A was observed walking about the classroom and documenting visual checks and sleep positions for Child 1 – 4, 6, and 7. When diapering for Child 5 was complete, Teacher B laid the child in the floor, went to the handwashing sink, and washed her hands. Teacher B then picked up Child 5 from the floor, took the child to the handwashing sink, and washed the child’s hands. While waiting for the child’s bottle to warm, Teacher B continued to hold and comfort Child 5 and keep the child quiet while Child 1 – 4, 6, and 7 were sleeping. Teacher B began to bottle fed Child 5 at 10:36am. At 10:36am, Child 4 awoke in their crib and Teacher A visually monitored Child 4 but did not pick the child up. Child 4 was lying quietly in their crib self-soothing by placing their hands in their mouth and then drifted back to sleep. At 10:38am, Child 1 – 4, 6, and 7 were observed sleeping in their cribs, Teacher A visually checking infants while sleeping, and Child 5 being bottle fed by Teacher B. I left the infant room at 10:45am. I re-entered the classroom for infant age children at 11:44am and observed four children awake and out of their cribs with Teacher A and Teacher B actively engaged in routine caregiving practices and interacting with children and three children asleep in their cribs. I re-entered the classroom for infant age children at 2:39pm and observed children in their cribs, the room darkened, and instrumental music playing. While in the classroom for infant age children, I reviewed the classroom daily schedule. I observed two scheduled naps for the infant age children from 10:00am to 12:00pm and from 2:30pm to 3:30pm included on the posted daily schedule. I reviewed the sleep charts for April 14, 2025, April 15, 2025, April 16, 2025, April 17, 2025, May 5, 2025, May 6, 2025, and today. On the sleep chart for April 14, 2025, six infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the six infant age children fell asleep from 10:16am to 11:00am. These records indicated that three additional infant age children went to sleep between 10:16am and 10:30am. These visual sleep check records indicated that one to three infant age children were awake from 10:16am to 12:15pm while other children were asleep in their cribs. By 12:30pm, records indicated that all six of the children were awake. On the sleep chart for April 14, 2025, five infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that the five infant age children fell asleep from 2:26pm to 2:54pm. These records indicated that from 2:26pm to 2:30pm, two infant age children were asleep and three infant age children were awake. From 2:26pm to 2:45pm, visual sleep check records indicated that one child was awake. Visual sleep check records indicated that all five infant age children were asleep from 2:54pm to 3:15pm. These records indicated that at 3:30pm two infant age children were awake, at 3:45pm three infant age children were awake, and by 4:00pm the five infant age children were awake. On the sleep chart for April 15, 2025, four infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the four infant age children fell asleep from 9:47am to 10:06am. Four infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the four infant age children fell asleep from 2:05pm to 2:56pm. On the sleep chart for April 16, 2025, six infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records that documented that the six infant age children fell asleep from 9:59am to 10:27am. Six infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the four infant age children fell asleep from 2:09pm to 2:45pm. On the sleep chart for April 17, 2025, five infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the five infant age children fell asleep from 10:00am to 10:47am. These records indicated that four children were awake from 10:00am to 10:15, from 10:15am to 10:28am two children were awake, and from 10:28am to 10:47am one child was awake. These visual sleep check records indicated that one infant age child was awake from 11:15am to 12:00pm while other children were asleep in their cribs. By 12:15pm, records indicated that all five of the children were awake. On the sleep chart for April 17, 2025, five infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the five infant age children fell asleep from 2:09pm to 2:25pm. These records indicated that from 2:09pm to 2:15pm, one infant age child was asleep and four infant age children were awake. Visual sleep check records indicated that all five infant age children were asleep from 2:30pm to 3:30pm. These records indicated that at 3:45pm one infant age child was awake and by 4:00pm the five infant age children were awake. On the sleep chart for May 5, 2025, seven infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the seven infant age children fell asleep from 9:47am to 10:03am. These visual sleep check records indicated that the infant age children to awake 10:45am to 12:00pm By 12:15pm, records indicated that all seven children were awake. On the sleep chart for May 5, 2025, seven infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that the seven infant age children fell asleep from 2:13pm to 3:20pm, however, these records also indicated that between 2:13pm and 4:00pm all seven children were not asleep at the same time. On the sleep chart for May 6, 2025, seven infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the seven infant age children fell asleep from 9:49am to 10:45am. The records indicated that different infant age children were awake one at a time between 9:49am and 11:15am while six other infant age children slept in their cribs. By 12:15pm, records indicated that all seven of the children were awake. On the sleep chart for May 6, 2025, seven infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that from 2:30pm to 2:50pm all seven infant age children fell asleep. These records indicated that from 2:30pm to 2:45pm, six infant age children were asleep and one infant age child was awake. Visual sleep check records indicated that all seven infant age children were asleep from 3:00pm to 3:30pm. These records indicated that at 3:45pm five infant age children were awake and by 4:00pm the seven infant age children were awake. Today, I interviewed four staff members. Staff stated that the daily classroom schedule included two naptime routines for the infant age children. Staff stated that as part of the naptime routine, teachers ensured each child was fed and diapered before laying the infant age child down in the crib. Staff stated that each child was transferred to their crib with the expectation that each infant age child would self-soothe and fall asleep. Staff stated that when an infant age child awakes from their nap or does not fall asleep, the child is allowed to lie in their crib and self-soothe quietly as long as other children are asleep in the room and the awake child does not need to be fed or diapered. Based on interviews with staff, review of the infant daily schedule, review of visual sleep check records, and my observations, the allegation of violations of child care requirements regarding activities/schedules/plans was confirmed. Therefore, the allegation was substantiated. I visited the room for infant age children to investigate the allegation of child care requirements regarding nutrition. As mentioned previously, seven infant age children were enrolled and present today with two teachers supervising the group. During my observations of the classroom, I observed infant age children being bottle fed and two infant age children being fed table food served from the kitchen. While in the classroom for infant age children, I reviewed the individual feeding plan for each enrolled child which were posted on the wall. I observed each individual feeding plan completed by the parent and then updated by the parent and/or the teachers as needed and required. I reviewed the children’s records for all the infant age children enrolled in the facility since March 2025 regardless of whether they currently attended the facility. While reviewing children’s records, I observed one individual feeding plan for one infant age child no longer enrolled in the classroom for infant age children whose individual feeding plan indicated that upon enrollment, the child was to be bottle fed 5 ounces of formula every three to four hours. This individual feeding plan indicated an update penned by the parent and initialed by a teacher requesting that the child be fed baby food with the first and second bottle of the day. This individual feeding plan indicated an update penned by the parent and initialed by the teacher requesting the child be fed table soft foods at breakfast, lunch, and snack and baby food when soft food was not available. This individual feeding plan indicated an update penned by the parent changing the five ounces of formula to be bottle fed every three to four hours to seven ounces of formula to be bottle fed every three to four hours. While reviewing children’s records for all the infant age children enrolled in the facility since March 2025 regardless of whether they currently attended the facility, I did not observe a chronic medical condition documented on child applications, medical action plan attached to applications, or orders from a health care professional documenting a chronic medical condition and specifying strict feeding instructions. I interviewed four staff members. Staff members stated that they follow the individual feeding plans for each infant age child. Staff members stated that they had not received instructions in writing or verbally requesting that any infant age child be awakened from nap to offer food on a strict schedule. Staff members stated that when children began eating baby food and/or table food, the child was served baby food and/or table food according to the schedule meals were served from the kitchen and bottles were still fed according to the individual feeding plan instructions. Staff members stated the frequency of the bottle feedings may be adjusted to avoid overfeeding the child. For example, if the individual feeding plan indicated that the child should be fed a bottle every three to four hours and the child had their last bottle at 6am and baby food for breakfast at 8:00am, the child would be offered the bottle closer to 10:00am stretching the three to four hours but staying within the feeding plan instructions. Staff members stated if a child missed a feeding of baby food due to an appointment, etc., the child was served baby food upon returning to the classroom unless the responsible adult had fed the child before returning the child to the classroom. Staff members stated if a child missed a feeding of table food due to an appointment, etc., the table food meal was stored appropriately in the kitchen until the child returned to the classroom and the kitchen staff would prepare the table food meal in the kitchen and deliver it to the classroom for the child to eat. Based on interviews with staff, review of children’s records for infant age children including individual feeding plans, and my observations, the allegation of violations of child care requirements regarding nutrition was not confirmed. Therefore, the allegation was unsubstantiated. I investigated the allegation of violations of child care requirements regarding supervision. I visited Space 1 where a total of seven infant age children were enrolled and present today with two teachers supervising the group. The children were observed in the classroom. I visited Space 2 where a total of eleven one- and two-year-old children were enrolled and present today with two teachers supervising the group. The children were observed in the classroom. I visited Space 3 where a total of twelve one- and two-year-old children were enrolled and present today with two teachers supervising the group. Three one-year-old children were observed playing on Outdoor Space 1 with one caregiver moving around the playground supervising the group. Nine two-year-old children were observed playing on Outdoor Space 2 with one caregiver moving around the playground supervising the group. I visited Outdoor Space 2 where children enrolled in Space 3, Space 4, and Space 5 were supervised by five teachers. Three groups/classrooms from Space 3, 4, and 5 were playing together on Outdoor Space 2 with five teachers supervising children ranging from two-years to four-years in age. Children were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, in the mulch area, and under the fire escape stairs. One teacher from Space 3 was moving around the playground supervising the children enrolled in Space 3. Two teachers from Space 4 and two teachers from Space 5 were standing in a row on the green artificial turf area approximately six feet apart from each other. These four teachers would turn their bodies to visually supervise the children and redirect children across the playground verbally from their spots on the green artificial turf area. In Space 4, a total of sixteen two- and three-year-old children were enrolled and fourteen two- and three-year-old children were present today with two teachers supervising the group. In Space 5, a total of ten three- and four-year-old children were enrolled and nine three- and four-year-old children were present today with two teachers supervising the group. In Space 6, a total of fourteen four- and five-year-old children were enrolled and twelve four- and five-year-old children were present today with two teachers supervising the group. I observed no staff members using personal cell phones indoors or outdoors when they should be actively supervising the children. I interviewed thirteen staff members. Staff members stated that staff do not use their personal cell phones while supervising children in the classrooms or on the playgrounds. Staff members stated that they have no concerns regarding other staff members using personal cell phones when they should be supervising children. While viewing live camera footage, I observed the two teachers from Space 4 move from their spots when they gathered their children to go indoors at the same time the group from Space 6 entered Outdoor Space 2. Two teachers from Space 5 were standing approximately six feet from each other on the green artificial turf area. One teacher from Space 6 was standing between the stationary composite piece and the man-made hill slide area. The second teacher from Space 6 was out of camera view which indicated she was too was positioned on the green artificial turf area closer to the wall because all other areas of the playground were in view of the camera except for the area behind the man-made hill slide area and I did not observe this teacher walk to that area. Children from Space 5 and 6 were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, and in the mulch area. During today’s visit, I observed children enrolled and present in Spaces 1 and 2 adequately supervised in classrooms. I observed children enrolled and present in Space 3 adequately supervised on the playground. Based on interviews with staff and my observations, the allegation of violations of child care requirements regarding supervision was not confirmed. Therefore, the allegation is unsubstantiated. However, based on my observations today, a violation related to supervision but unrelated to the allegation was cited and technical assistance was provided. Staff-child ratios, adequate space capacity, and approved space use were maintained during today’s visit. The facility permit was posted, and permit restrictions were maintained during today’s visit. The following violations were observed and cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. While on Outdoor Space 2, five teachers from Spaces 4, 5, and 6 did not adequately supervise children ranging in age from two-years to five-years. .1801(a)(1-5) 424 For children under two years of age, individualized caregiving routines such as eating, napping and toileting was not interspersed among the daily events. In the classroom for infant age care, naps were offered according to a scheduled morning naptime from 10:00am to 12:00pm and an afternoon naptime from 2:30pm to 3:30pm. Upon waking from sleep during the scheduled naptimes, infant age children were left in their cribs to self-soothe while other infant age children slept. .0508( e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times in child care centers. As stated in child care rule, adequate supervision means that: (1) staff are positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff interact with the children while moving about the indoor or outdoor area; (3) staff know where each child is located and are aware of the children's activities at all times; (4) staff provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff are able to see and hear children aged birth to five years old while the children are eating. Today, while monitoring outdoors, I observed three groups/classrooms from Space 3, 4, and 5 playing together on Outdoor Space 2 with five teachers supervising children ranging from two-years to four-years in age. Children were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, in the mulch area, and under the fire escape stairs. One teacher from Space 3 was moving around the playground supervising the children enrolled in Space 3. Two teachers from Space 4 and two teachers from Space 5 were standing in a row on the green artificial turf area approximately six feet apart from each other. These four teachers would turn their bodies to visually supervise the children and redirect children across the playground verbally from their spots on the green artificial turf area. While viewing camera footage, I observed the two teachers in Space 4 move from their spots when they gathered their children to go indoors at the same time the group from Space 6 entered Outdoor Space 2. Two teachers from Space 5 were standing approximately six feet from each other on the green artificial turf area. One teacher from Space 6 was standing between the stationary composite piece and the man-made hill slide area. The second teacher from Space 6 was out of camera view which indicated she was too was positioned on the green artificial turf area closer to the wall because all other areas of the playground were in view of the camera except for the area behind the man-made hill slide area and I did not observe this teacher walk to that area. Children from Space 5 and 6 were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, and in the mulch area. To maintain compliance with this child care requirement, I advised you to encourage teachers to share supervision responsibilities when multiple groups of children were on the playground at the same time. I suggested you train teachers to separate themselves into four main areas/zones of the playgrounds and walk around interacting with the children within those four main areas/zones. I advised you to consider providing a supervision training opportunity for your staff and hold a staff meeting after the training to review your facility’s supervision policy and expectations. 2. Per child care rule 10A NCAC 09 .0508(e), for children under two years of age, individualized caregiving routines such as eating, napping and toileting should be interspersed among the daily events. During today’s visit, I observed the infant daily classroom schedule included a morning nap from 10:00am to 12:00pm and an afternoon nap from 2:30pm to 3:30pm. I observed infant age children asleep in cribs during the 10:00am to 12:00pm time period and between the 2:30pm to 3:30pm time period. During today’s visit, staff stated that the infant daily classroom schedule included two naptime routines for the infant age children. Staff stated that as part of the naptime routine, teachers ensured each child was fed and diapered before laying each infant age child down in their crib. Staff stated that each child was transferred to their crib with the expectation that each infant age child would self-soothe and fall asleep. Staff stated that when an infant age child awakes from their nap or does not fall asleep, the child is allowed to lie in their crib and self-soothe quietly as long as other children are asleep in the room and the awake child does not need to be fed or diapered. Staff stated that on the visual sleep check records, the first documented time indicated the time that the infant age child fell asleep. Staff stated that they do not record the time or position that the child was laid down in the crib but do record the child’s sleep position and time that the child falls asleep. After reviewing visual sleep check records, I was able to confirm the staff’s statements. As discussed today, while including naptime routines, feeding routines, and diapering routines in an infant daily schedule is a common and accepted practice, expecting all infant age children to adhere to this schedule is not acceptable. Child care rule requires each infant age child to be fed, diapered, and allowed to sleep as needed according to each infant age child’s individual needs and wants. Child care rule requires teachers to interact with children during their waking hours. Just as each infant age child gives cues to alert the teacher that they are hungry, infant age children will also give cues that they are sleepy, bored, and uncomfortable. Teachers providing infant age care should use each infant’s cues to provide the individualized care that each child needs. As discussed today, when an infant age child is awake and other children in the classroom are asleep, that is a good time for the child to be taken from the crib and provided supervised tummy-time, outdoor time, or other individualized planned activities documented on the activity plan. To maintain compliance with this child care requirement, I suggest you review child care rule section 10A NCAC 09 .0508 Activity Schedules And Plans and section 10A NCAC 09 .0511 Daily Routines For Children Under Two Years Of Age with all staff that may regularly work in the classroom with infant age children or may be asked to work in the classroom with infant age children from time to time. I also suggested you revise the infant daily classroom schedule to include a clause the states the following, “While this schedule includes all the activities we will offer your child throughout the day, the times will vary based on the individual needs of each infant age child and will documented in each child’s daily ‘Bright Wheel’ report.” Lastly, I suggested you use the “Infant Sleep Chart” sample provided on the DCDEE website under “Provider Documents and Forms”. This document will allow teachers space to document the date, time, and position of each child when the child is laid down in the crib, as well as the time and position when the child goes to sleep. CONSULTATION: 1. During today’s visit, I observed the classroom for infant age children darkened by a room-darkening shade covering the only oversized window at the back of the room and the classroom lights turned off. I observed a privacy glass window in the classroom door which provided the only light entering the room from the florescent lighting in the hallway. It took my eyes several minutes to adjust to the lack of light and feel safe to move about the classroom without injury. I had to walk to the classroom door to see and write my notes. As discussed today, when the classroom is this dark, it is too dark and an unsafe environment for staff and visitors. I suggest you increase the amount of light in the classroom when the infant age children are asleep either by slightly raising the room-darkening shade or by placing a small table lamp with a low wattage bulb on top of the refrigerator with the cord hidden behind the refrigerator or on the counter at the food preparation area with the cord unreachable by the infant age children. 2. During today’s visit, I also observed instrumental music playing in the classroom for infant age children at a volume that made it difficult for me to hear the teachers when I spoke with them. When the music is this loud, it is too loud and an unsafe environment for children and staff. I suggest you decrease the volume of the music to allow staff to speak each other at a normal volume and hear each other and an emergency alerts that may be made by the administrative staff. 3. Per child care rule 10A NCAC 09 .0508(c), for children under 2 years of age, a minimum of thirty minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity should be provided weather permitting. During today’s visit, I observed the infant daily classroom schedule included outdoor time from 1:00pm to 1:30pm. At 1:13pm, I entered the classroom for infant age children and asked the teachers when the children would taken outside today. One teacher stated that infant age children are not always taken outside every day because the feeding, diapering, and napping schedules do not always allow for outside time. As explained today, child care rule requires a total of thirty minutes of outside time throughout the caregiving day and can be provided by one teacher staying in the classroom and the second teacher taking individual children or small groups of infant age children at similar development levels to the infant/toddler playground, by a teacher assistant coming in the classroom to assist with routine care while a teacher takes children outside, or by a teacher assistant coming in the classroom and taking children outside. 4. As discussed today, the original copy of the “Individual Feeding Plan” should be placed in each infant child’s record file when the child leaves the facility or when the child reaches fifteen months of age. Best practice is to keep each child’s “Individual Feeding Plan” on file with all other child record documents as long as the child is enrolled in the facility and for at least one year after the child is no longer enrolled in the facility. 5. As discussed, one violation cited during today’s visit will require a follow-up visit within two weeks. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than May 21, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. A computer-generated visit summary was prepared and a printed copy will be shared with you during the required follow-up visit. We appreciate all you and your staff are doing to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0511 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 0425-278L Visit Date: 5/7/2025 Number Present: 65 Completed Date: 5/7/2025 Age: From 0 To 5 Total Minutes: 348 Time In: 10:03 AM Time Out: 01:15 PM Time In: 02:39 PM Time Out: 05:15 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to gather information related to allegations of violations of child care requirements. You, Susan Rowe, Assistant Director, assisted me with the visit. Your compliance history prior to today’s visit was 87% prior to today’s visit. You stated you had seventy children enrolled ranging from infant to five-years of age with sixty-five children ranging from infant to five-years of age present today. According to the report, there are allegations of violations of child care requirements regarding activities/schedules/plans, nutrition, and supervision. I visited the room for infant age children to investigate the allegation of child care requirements regarding activities/schedules/plans. Seven infant age children (Child 1 – 7) were enrolled and present in the classroom today with two teachers (Teacher A and Teacher B) supervising the group. At approximately 10:05am, I entered the classroom for infant age children. I observed Child 1 – 5 sleeping in their cribs. Teacher A was bottle feeding Child 6 while holding and rocking the child. Teacher B was bottle feeding Child 7 while holding and rocking the child. At 10:13am, Child 6 completed their bottle. Child 6 had fallen asleep while taking their bottle and Teacher A laid the sleeping Child 6 down in their crib. At 10:25am, Child 7 completed their bottle and Teacher B transferred the child to their crib. Child 7 was observed awake upon being laid in their crib. Child 7 was asleep at 10:29am. Teacher B retrieved a bottle from the refrigerator and placed it in the warmer. At 10:29, Child 5 awoke from their nap and began to whine. Teacher B picked up Child 5 from the crib and comforted the child while carrying Child 5 to the diaper changing table where the child’s diaper was changed. Teacher A was observed walking about the classroom and documenting visual checks and sleep positions for Child 1 – 4, 6, and 7. When diapering for Child 5 was complete, Teacher B laid the child in the floor, went to the handwashing sink, and washed her hands. Teacher B then picked up Child 5 from the floor, took the child to the handwashing sink, and washed the child’s hands. While waiting for the child’s bottle to warm, Teacher B continued to hold and comfort Child 5 and keep the child quiet while Child 1 – 4, 6, and 7 were sleeping. Teacher B began to bottle fed Child 5 at 10:36am. At 10:36am, Child 4 awoke in their crib and Teacher A visually monitored Child 4 but did not pick the child up. Child 4 was lying quietly in their crib self-soothing by placing their hands in their mouth and then drifted back to sleep. At 10:38am, Child 1 – 4, 6, and 7 were observed sleeping in their cribs, Teacher A visually checking infants while sleeping, and Child 5 being bottle fed by Teacher B. I left the infant room at 10:45am. I re-entered the classroom for infant age children at 11:44am and observed four children awake and out of their cribs with Teacher A and Teacher B actively engaged in routine caregiving practices and interacting with children and three children asleep in their cribs. I re-entered the classroom for infant age children at 2:39pm and observed children in their cribs, the room darkened, and instrumental music playing. While in the classroom for infant age children, I reviewed the classroom daily schedule. I observed two scheduled naps for the infant age children from 10:00am to 12:00pm and from 2:30pm to 3:30pm included on the posted daily schedule. I reviewed the sleep charts for April 14, 2025, April 15, 2025, April 16, 2025, April 17, 2025, May 5, 2025, May 6, 2025, and today. On the sleep chart for April 14, 2025, six infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the six infant age children fell asleep from 10:16am to 11:00am. These records indicated that three additional infant age children went to sleep between 10:16am and 10:30am. These visual sleep check records indicated that one to three infant age children were awake from 10:16am to 12:15pm while other children were asleep in their cribs. By 12:30pm, records indicated that all six of the children were awake. On the sleep chart for April 14, 2025, five infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that the five infant age children fell asleep from 2:26pm to 2:54pm. These records indicated that from 2:26pm to 2:30pm, two infant age children were asleep and three infant age children were awake. From 2:26pm to 2:45pm, visual sleep check records indicated that one child was awake. Visual sleep check records indicated that all five infant age children were asleep from 2:54pm to 3:15pm. These records indicated that at 3:30pm two infant age children were awake, at 3:45pm three infant age children were awake, and by 4:00pm the five infant age children were awake. On the sleep chart for April 15, 2025, four infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the four infant age children fell asleep from 9:47am to 10:06am. Four infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the four infant age children fell asleep from 2:05pm to 2:56pm. On the sleep chart for April 16, 2025, six infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records that documented that the six infant age children fell asleep from 9:59am to 10:27am. Six infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the four infant age children fell asleep from 2:09pm to 2:45pm. On the sleep chart for April 17, 2025, five infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the five infant age children fell asleep from 10:00am to 10:47am. These records indicated that four children were awake from 10:00am to 10:15, from 10:15am to 10:28am two children were awake, and from 10:28am to 10:47am one child was awake. These visual sleep check records indicated that one infant age child was awake from 11:15am to 12:00pm while other children were asleep in their cribs. By 12:15pm, records indicated that all five of the children were awake. On the sleep chart for April 17, 2025, five infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the five infant age children fell asleep from 2:09pm to 2:25pm. These records indicated that from 2:09pm to 2:15pm, one infant age child was asleep and four infant age children were awake. Visual sleep check records indicated that all five infant age children were asleep from 2:30pm to 3:30pm. These records indicated that at 3:45pm one infant age child was awake and by 4:00pm the five infant age children were awake. On the sleep chart for May 5, 2025, seven infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the seven infant age children fell asleep from 9:47am to 10:03am. These visual sleep check records indicated that the infant age children to awake 10:45am to 12:00pm By 12:15pm, records indicated that all seven children were awake. On the sleep chart for May 5, 2025, seven infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that the seven infant age children fell asleep from 2:13pm to 3:20pm, however, these records also indicated that between 2:13pm and 4:00pm all seven children were not asleep at the same time. On the sleep chart for May 6, 2025, seven infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the seven infant age children fell asleep from 9:49am to 10:45am. The records indicated that different infant age children were awake one at a time between 9:49am and 11:15am while six other infant age children slept in their cribs. By 12:15pm, records indicated that all seven of the children were awake. On the sleep chart for May 6, 2025, seven infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that from 2:30pm to 2:50pm all seven infant age children fell asleep. These records indicated that from 2:30pm to 2:45pm, six infant age children were asleep and one infant age child was awake. Visual sleep check records indicated that all seven infant age children were asleep from 3:00pm to 3:30pm. These records indicated that at 3:45pm five infant age children were awake and by 4:00pm the seven infant age children were awake. Today, I interviewed four staff members. Staff stated that the daily classroom schedule included two naptime routines for the infant age children. Staff stated that as part of the naptime routine, teachers ensured each child was fed and diapered before laying the infant age child down in the crib. Staff stated that each child was transferred to their crib with the expectation that each infant age child would self-soothe and fall asleep. Staff stated that when an infant age child awakes from their nap or does not fall asleep, the child is allowed to lie in their crib and self-soothe quietly as long as other children are asleep in the room and the awake child does not need to be fed or diapered. Based on interviews with staff, review of the infant daily schedule, review of visual sleep check records, and my observations, the allegation of violations of child care requirements regarding activities/schedules/plans was confirmed. Therefore, the allegation was substantiated. I visited the room for infant age children to investigate the allegation of child care requirements regarding nutrition. As mentioned previously, seven infant age children were enrolled and present today with two teachers supervising the group. During my observations of the classroom, I observed infant age children being bottle fed and two infant age children being fed table food served from the kitchen. While in the classroom for infant age children, I reviewed the individual feeding plan for each enrolled child which were posted on the wall. I observed each individual feeding plan completed by the parent and then updated by the parent and/or the teachers as needed and required. I reviewed the children’s records for all the infant age children enrolled in the facility since March 2025 regardless of whether they currently attended the facility. While reviewing children’s records, I observed one individual feeding plan for one infant age child no longer enrolled in the classroom for infant age children whose individual feeding plan indicated that upon enrollment, the child was to be bottle fed 5 ounces of formula every three to four hours. This individual feeding plan indicated an update penned by the parent and initialed by a teacher requesting that the child be fed baby food with the first and second bottle of the day. This individual feeding plan indicated an update penned by the parent and initialed by the teacher requesting the child be fed table soft foods at breakfast, lunch, and snack and baby food when soft food was not available. This individual feeding plan indicated an update penned by the parent changing the five ounces of formula to be bottle fed every three to four hours to seven ounces of formula to be bottle fed every three to four hours. While reviewing children’s records for all the infant age children enrolled in the facility since March 2025 regardless of whether they currently attended the facility, I did not observe a chronic medical condition documented on child applications, medical action plan attached to applications, or orders from a health care professional documenting a chronic medical condition and specifying strict feeding instructions. I interviewed four staff members. Staff members stated that they follow the individual feeding plans for each infant age child. Staff members stated that they had not received instructions in writing or verbally requesting that any infant age child be awakened from nap to offer food on a strict schedule. Staff members stated that when children began eating baby food and/or table food, the child was served baby food and/or table food according to the schedule meals were served from the kitchen and bottles were still fed according to the individual feeding plan instructions. Staff members stated the frequency of the bottle feedings may be adjusted to avoid overfeeding the child. For example, if the individual feeding plan indicated that the child should be fed a bottle every three to four hours and the child had their last bottle at 6am and baby food for breakfast at 8:00am, the child would be offered the bottle closer to 10:00am stretching the three to four hours but staying within the feeding plan instructions. Staff members stated if a child missed a feeding of baby food due to an appointment, etc., the child was served baby food upon returning to the classroom unless the responsible adult had fed the child before returning the child to the classroom. Staff members stated if a child missed a feeding of table food due to an appointment, etc., the table food meal was stored appropriately in the kitchen until the child returned to the classroom and the kitchen staff would prepare the table food meal in the kitchen and deliver it to the classroom for the child to eat. Based on interviews with staff, review of children’s records for infant age children including individual feeding plans, and my observations, the allegation of violations of child care requirements regarding nutrition was not confirmed. Therefore, the allegation was unsubstantiated. I investigated the allegation of violations of child care requirements regarding supervision. I visited Space 1 where a total of seven infant age children were enrolled and present today with two teachers supervising the group. The children were observed in the classroom. I visited Space 2 where a total of eleven one- and two-year-old children were enrolled and present today with two teachers supervising the group. The children were observed in the classroom. I visited Space 3 where a total of twelve one- and two-year-old children were enrolled and present today with two teachers supervising the group. Three one-year-old children were observed playing on Outdoor Space 1 with one caregiver moving around the playground supervising the group. Nine two-year-old children were observed playing on Outdoor Space 2 with one caregiver moving around the playground supervising the group. I visited Outdoor Space 2 where children enrolled in Space 3, Space 4, and Space 5 were supervised by five teachers. Three groups/classrooms from Space 3, 4, and 5 were playing together on Outdoor Space 2 with five teachers supervising children ranging from two-years to four-years in age. Children were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, in the mulch area, and under the fire escape stairs. One teacher from Space 3 was moving around the playground supervising the children enrolled in Space 3. Two teachers from Space 4 and two teachers from Space 5 were standing in a row on the green artificial turf area approximately six feet apart from each other. These four teachers would turn their bodies to visually supervise the children and redirect children across the playground verbally from their spots on the green artificial turf area. In Space 4, a total of sixteen two- and three-year-old children were enrolled and fourteen two- and three-year-old children were present today with two teachers supervising the group. In Space 5, a total of ten three- and four-year-old children were enrolled and nine three- and four-year-old children were present today with two teachers supervising the group. In Space 6, a total of fourteen four- and five-year-old children were enrolled and twelve four- and five-year-old children were present today with two teachers supervising the group. I observed no staff members using personal cell phones indoors or outdoors when they should be actively supervising the children. I interviewed thirteen staff members. Staff members stated that staff do not use their personal cell phones while supervising children in the classrooms or on the playgrounds. Staff members stated that they have no concerns regarding other staff members using personal cell phones when they should be supervising children. While viewing live camera footage, I observed the two teachers from Space 4 move from their spots when they gathered their children to go indoors at the same time the group from Space 6 entered Outdoor Space 2. Two teachers from Space 5 were standing approximately six feet from each other on the green artificial turf area. One teacher from Space 6 was standing between the stationary composite piece and the man-made hill slide area. The second teacher from Space 6 was out of camera view which indicated she was too was positioned on the green artificial turf area closer to the wall because all other areas of the playground were in view of the camera except for the area behind the man-made hill slide area and I did not observe this teacher walk to that area. Children from Space 5 and 6 were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, and in the mulch area. During today’s visit, I observed children enrolled and present in Spaces 1 and 2 adequately supervised in classrooms. I observed children enrolled and present in Space 3 adequately supervised on the playground. Based on interviews with staff and my observations, the allegation of violations of child care requirements regarding supervision was not confirmed. Therefore, the allegation is unsubstantiated. However, based on my observations today, a violation related to supervision but unrelated to the allegation was cited and technical assistance was provided. Staff-child ratios, adequate space capacity, and approved space use were maintained during today’s visit. The facility permit was posted, and permit restrictions were maintained during today’s visit. The following violations were observed and cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. While on Outdoor Space 2, five teachers from Spaces 4, 5, and 6 did not adequately supervise children ranging in age from two-years to five-years. .1801(a)(1-5) 424 For children under two years of age, individualized caregiving routines such as eating, napping and toileting was not interspersed among the daily events. In the classroom for infant age care, naps were offered according to a scheduled morning naptime from 10:00am to 12:00pm and an afternoon naptime from 2:30pm to 3:30pm. Upon waking from sleep during the scheduled naptimes, infant age children were left in their cribs to self-soothe while other infant age children slept. .0508( e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times in child care centers. As stated in child care rule, adequate supervision means that: (1) staff are positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff interact with the children while moving about the indoor or outdoor area; (3) staff know where each child is located and are aware of the children's activities at all times; (4) staff provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff are able to see and hear children aged birth to five years old while the children are eating. Today, while monitoring outdoors, I observed three groups/classrooms from Space 3, 4, and 5 playing together on Outdoor Space 2 with five teachers supervising children ranging from two-years to four-years in age. Children were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, in the mulch area, and under the fire escape stairs. One teacher from Space 3 was moving around the playground supervising the children enrolled in Space 3. Two teachers from Space 4 and two teachers from Space 5 were standing in a row on the green artificial turf area approximately six feet apart from each other. These four teachers would turn their bodies to visually supervise the children and redirect children across the playground verbally from their spots on the green artificial turf area. While viewing camera footage, I observed the two teachers in Space 4 move from their spots when they gathered their children to go indoors at the same time the group from Space 6 entered Outdoor Space 2. Two teachers from Space 5 were standing approximately six feet from each other on the green artificial turf area. One teacher from Space 6 was standing between the stationary composite piece and the man-made hill slide area. The second teacher from Space 6 was out of camera view which indicated she was too was positioned on the green artificial turf area closer to the wall because all other areas of the playground were in view of the camera except for the area behind the man-made hill slide area and I did not observe this teacher walk to that area. Children from Space 5 and 6 were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, and in the mulch area. To maintain compliance with this child care requirement, I advised you to encourage teachers to share supervision responsibilities when multiple groups of children were on the playground at the same time. I suggested you train teachers to separate themselves into four main areas/zones of the playgrounds and walk around interacting with the children within those four main areas/zones. I advised you to consider providing a supervision training opportunity for your staff and hold a staff meeting after the training to review your facility’s supervision policy and expectations. 2. Per child care rule 10A NCAC 09 .0508(e), for children under two years of age, individualized caregiving routines such as eating, napping and toileting should be interspersed among the daily events. During today’s visit, I observed the infant daily classroom schedule included a morning nap from 10:00am to 12:00pm and an afternoon nap from 2:30pm to 3:30pm. I observed infant age children asleep in cribs during the 10:00am to 12:00pm time period and between the 2:30pm to 3:30pm time period. During today’s visit, staff stated that the infant daily classroom schedule included two naptime routines for the infant age children. Staff stated that as part of the naptime routine, teachers ensured each child was fed and diapered before laying each infant age child down in their crib. Staff stated that each child was transferred to their crib with the expectation that each infant age child would self-soothe and fall asleep. Staff stated that when an infant age child awakes from their nap or does not fall asleep, the child is allowed to lie in their crib and self-soothe quietly as long as other children are asleep in the room and the awake child does not need to be fed or diapered. Staff stated that on the visual sleep check records, the first documented time indicated the time that the infant age child fell asleep. Staff stated that they do not record the time or position that the child was laid down in the crib but do record the child’s sleep position and time that the child falls asleep. After reviewing visual sleep check records, I was able to confirm the staff’s statements. As discussed today, while including naptime routines, feeding routines, and diapering routines in an infant daily schedule is a common and accepted practice, expecting all infant age children to adhere to this schedule is not acceptable. Child care rule requires each infant age child to be fed, diapered, and allowed to sleep as needed according to each infant age child’s individual needs and wants. Child care rule requires teachers to interact with children during their waking hours. Just as each infant age child gives cues to alert the teacher that they are hungry, infant age children will also give cues that they are sleepy, bored, and uncomfortable. Teachers providing infant age care should use each infant’s cues to provide the individualized care that each child needs. As discussed today, when an infant age child is awake and other children in the classroom are asleep, that is a good time for the child to be taken from the crib and provided supervised tummy-time, outdoor time, or other individualized planned activities documented on the activity plan. To maintain compliance with this child care requirement, I suggest you review child care rule section 10A NCAC 09 .0508 Activity Schedules And Plans and section 10A NCAC 09 .0511 Daily Routines For Children Under Two Years Of Age with all staff that may regularly work in the classroom with infant age children or may be asked to work in the classroom with infant age children from time to time. I also suggested you revise the infant daily classroom schedule to include a clause the states the following, “While this schedule includes all the activities we will offer your child throughout the day, the times will vary based on the individual needs of each infant age child and will documented in each child’s daily ‘Bright Wheel’ report.” Lastly, I suggested you use the “Infant Sleep Chart” sample provided on the DCDEE website under “Provider Documents and Forms”. This document will allow teachers space to document the date, time, and position of each child when the child is laid down in the crib, as well as the time and position when the child goes to sleep. CONSULTATION: 1. During today’s visit, I observed the classroom for infant age children darkened by a room-darkening shade covering the only oversized window at the back of the room and the classroom lights turned off. I observed a privacy glass window in the classroom door which provided the only light entering the room from the florescent lighting in the hallway. It took my eyes several minutes to adjust to the lack of light and feel safe to move about the classroom without injury. I had to walk to the classroom door to see and write my notes. As discussed today, when the classroom is this dark, it is too dark and an unsafe environment for staff and visitors. I suggest you increase the amount of light in the classroom when the infant age children are asleep either by slightly raising the room-darkening shade or by placing a small table lamp with a low wattage bulb on top of the refrigerator with the cord hidden behind the refrigerator or on the counter at the food preparation area with the cord unreachable by the infant age children. 2. During today’s visit, I also observed instrumental music playing in the classroom for infant age children at a volume that made it difficult for me to hear the teachers when I spoke with them. When the music is this loud, it is too loud and an unsafe environment for children and staff. I suggest you decrease the volume of the music to allow staff to speak each other at a normal volume and hear each other and an emergency alerts that may be made by the administrative staff. 3. Per child care rule 10A NCAC 09 .0508(c), for children under 2 years of age, a minimum of thirty minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity should be provided weather permitting. During today’s visit, I observed the infant daily classroom schedule included outdoor time from 1:00pm to 1:30pm. At 1:13pm, I entered the classroom for infant age children and asked the teachers when the children would taken outside today. One teacher stated that infant age children are not always taken outside every day because the feeding, diapering, and napping schedules do not always allow for outside time. As explained today, child care rule requires a total of thirty minutes of outside time throughout the caregiving day and can be provided by one teacher staying in the classroom and the second teacher taking individual children or small groups of infant age children at similar development levels to the infant/toddler playground, by a teacher assistant coming in the classroom to assist with routine care while a teacher takes children outside, or by a teacher assistant coming in the classroom and taking children outside. 4. As discussed today, the original copy of the “Individual Feeding Plan” should be placed in each infant child’s record file when the child leaves the facility or when the child reaches fifteen months of age. Best practice is to keep each child’s “Individual Feeding Plan” on file with all other child record documents as long as the child is enrolled in the facility and for at least one year after the child is no longer enrolled in the facility. 5. As discussed, one violation cited during today’s visit will require a follow-up visit within two weeks. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than May 21, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. A computer-generated visit summary was prepared and a printed copy will be shared with you during the required follow-up visit. We appreciate all you and your staff are doing to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 0425-278L Visit Date: 5/7/2025 Number Present: 65 Completed Date: 5/7/2025 Age: From 0 To 5 Total Minutes: 348 Time In: 10:03 AM Time Out: 01:15 PM Time In: 02:39 PM Time Out: 05:15 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to gather information related to allegations of violations of child care requirements. You, Susan Rowe, Assistant Director, assisted me with the visit. Your compliance history prior to today’s visit was 87% prior to today’s visit. You stated you had seventy children enrolled ranging from infant to five-years of age with sixty-five children ranging from infant to five-years of age present today. According to the report, there are allegations of violations of child care requirements regarding activities/schedules/plans, nutrition, and supervision. I visited the room for infant age children to investigate the allegation of child care requirements regarding activities/schedules/plans. Seven infant age children (Child 1 – 7) were enrolled and present in the classroom today with two teachers (Teacher A and Teacher B) supervising the group. At approximately 10:05am, I entered the classroom for infant age children. I observed Child 1 – 5 sleeping in their cribs. Teacher A was bottle feeding Child 6 while holding and rocking the child. Teacher B was bottle feeding Child 7 while holding and rocking the child. At 10:13am, Child 6 completed their bottle. Child 6 had fallen asleep while taking their bottle and Teacher A laid the sleeping Child 6 down in their crib. At 10:25am, Child 7 completed their bottle and Teacher B transferred the child to their crib. Child 7 was observed awake upon being laid in their crib. Child 7 was asleep at 10:29am. Teacher B retrieved a bottle from the refrigerator and placed it in the warmer. At 10:29, Child 5 awoke from their nap and began to whine. Teacher B picked up Child 5 from the crib and comforted the child while carrying Child 5 to the diaper changing table where the child’s diaper was changed. Teacher A was observed walking about the classroom and documenting visual checks and sleep positions for Child 1 – 4, 6, and 7. When diapering for Child 5 was complete, Teacher B laid the child in the floor, went to the handwashing sink, and washed her hands. Teacher B then picked up Child 5 from the floor, took the child to the handwashing sink, and washed the child’s hands. While waiting for the child’s bottle to warm, Teacher B continued to hold and comfort Child 5 and keep the child quiet while Child 1 – 4, 6, and 7 were sleeping. Teacher B began to bottle fed Child 5 at 10:36am. At 10:36am, Child 4 awoke in their crib and Teacher A visually monitored Child 4 but did not pick the child up. Child 4 was lying quietly in their crib self-soothing by placing their hands in their mouth and then drifted back to sleep. At 10:38am, Child 1 – 4, 6, and 7 were observed sleeping in their cribs, Teacher A visually checking infants while sleeping, and Child 5 being bottle fed by Teacher B. I left the infant room at 10:45am. I re-entered the classroom for infant age children at 11:44am and observed four children awake and out of their cribs with Teacher A and Teacher B actively engaged in routine caregiving practices and interacting with children and three children asleep in their cribs. I re-entered the classroom for infant age children at 2:39pm and observed children in their cribs, the room darkened, and instrumental music playing. While in the classroom for infant age children, I reviewed the classroom daily schedule. I observed two scheduled naps for the infant age children from 10:00am to 12:00pm and from 2:30pm to 3:30pm included on the posted daily schedule. I reviewed the sleep charts for April 14, 2025, April 15, 2025, April 16, 2025, April 17, 2025, May 5, 2025, May 6, 2025, and today. On the sleep chart for April 14, 2025, six infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the six infant age children fell asleep from 10:16am to 11:00am. These records indicated that three additional infant age children went to sleep between 10:16am and 10:30am. These visual sleep check records indicated that one to three infant age children were awake from 10:16am to 12:15pm while other children were asleep in their cribs. By 12:30pm, records indicated that all six of the children were awake. On the sleep chart for April 14, 2025, five infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that the five infant age children fell asleep from 2:26pm to 2:54pm. These records indicated that from 2:26pm to 2:30pm, two infant age children were asleep and three infant age children were awake. From 2:26pm to 2:45pm, visual sleep check records indicated that one child was awake. Visual sleep check records indicated that all five infant age children were asleep from 2:54pm to 3:15pm. These records indicated that at 3:30pm two infant age children were awake, at 3:45pm three infant age children were awake, and by 4:00pm the five infant age children were awake. On the sleep chart for April 15, 2025, four infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the four infant age children fell asleep from 9:47am to 10:06am. Four infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the four infant age children fell asleep from 2:05pm to 2:56pm. On the sleep chart for April 16, 2025, six infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records that documented that the six infant age children fell asleep from 9:59am to 10:27am. Six infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the four infant age children fell asleep from 2:09pm to 2:45pm. On the sleep chart for April 17, 2025, five infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the five infant age children fell asleep from 10:00am to 10:47am. These records indicated that four children were awake from 10:00am to 10:15, from 10:15am to 10:28am two children were awake, and from 10:28am to 10:47am one child was awake. These visual sleep check records indicated that one infant age child was awake from 11:15am to 12:00pm while other children were asleep in their cribs. By 12:15pm, records indicated that all five of the children were awake. On the sleep chart for April 17, 2025, five infant children were in attendance during the afternoon nap routine with one teacher supervising. Visual sleep check records documented that the five infant age children fell asleep from 2:09pm to 2:25pm. These records indicated that from 2:09pm to 2:15pm, one infant age child was asleep and four infant age children were awake. Visual sleep check records indicated that all five infant age children were asleep from 2:30pm to 3:30pm. These records indicated that at 3:45pm one infant age child was awake and by 4:00pm the five infant age children were awake. On the sleep chart for May 5, 2025, seven infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the seven infant age children fell asleep from 9:47am to 10:03am. These visual sleep check records indicated that the infant age children to awake 10:45am to 12:00pm By 12:15pm, records indicated that all seven children were awake. On the sleep chart for May 5, 2025, seven infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that the seven infant age children fell asleep from 2:13pm to 3:20pm, however, these records also indicated that between 2:13pm and 4:00pm all seven children were not asleep at the same time. On the sleep chart for May 6, 2025, seven infant children were in attendance with two teachers supervising during the morning nap routine. Visual sleep check records documented that the seven infant age children fell asleep from 9:49am to 10:45am. The records indicated that different infant age children were awake one at a time between 9:49am and 11:15am while six other infant age children slept in their cribs. By 12:15pm, records indicated that all seven of the children were awake. On the sleep chart for May 6, 2025, seven infant children were in attendance during the afternoon nap routine with one to two teachers supervising. Visual sleep check records documented that from 2:30pm to 2:50pm all seven infant age children fell asleep. These records indicated that from 2:30pm to 2:45pm, six infant age children were asleep and one infant age child was awake. Visual sleep check records indicated that all seven infant age children were asleep from 3:00pm to 3:30pm. These records indicated that at 3:45pm five infant age children were awake and by 4:00pm the seven infant age children were awake. Today, I interviewed four staff members. Staff stated that the daily classroom schedule included two naptime routines for the infant age children. Staff stated that as part of the naptime routine, teachers ensured each child was fed and diapered before laying the infant age child down in the crib. Staff stated that each child was transferred to their crib with the expectation that each infant age child would self-soothe and fall asleep. Staff stated that when an infant age child awakes from their nap or does not fall asleep, the child is allowed to lie in their crib and self-soothe quietly as long as other children are asleep in the room and the awake child does not need to be fed or diapered. Based on interviews with staff, review of the infant daily schedule, review of visual sleep check records, and my observations, the allegation of violations of child care requirements regarding activities/schedules/plans was confirmed. Therefore, the allegation was substantiated. I visited the room for infant age children to investigate the allegation of child care requirements regarding nutrition. As mentioned previously, seven infant age children were enrolled and present today with two teachers supervising the group. During my observations of the classroom, I observed infant age children being bottle fed and two infant age children being fed table food served from the kitchen. While in the classroom for infant age children, I reviewed the individual feeding plan for each enrolled child which were posted on the wall. I observed each individual feeding plan completed by the parent and then updated by the parent and/or the teachers as needed and required. I reviewed the children’s records for all the infant age children enrolled in the facility since March 2025 regardless of whether they currently attended the facility. While reviewing children’s records, I observed one individual feeding plan for one infant age child no longer enrolled in the classroom for infant age children whose individual feeding plan indicated that upon enrollment, the child was to be bottle fed 5 ounces of formula every three to four hours. This individual feeding plan indicated an update penned by the parent and initialed by a teacher requesting that the child be fed baby food with the first and second bottle of the day. This individual feeding plan indicated an update penned by the parent and initialed by the teacher requesting the child be fed table soft foods at breakfast, lunch, and snack and baby food when soft food was not available. This individual feeding plan indicated an update penned by the parent changing the five ounces of formula to be bottle fed every three to four hours to seven ounces of formula to be bottle fed every three to four hours. While reviewing children’s records for all the infant age children enrolled in the facility since March 2025 regardless of whether they currently attended the facility, I did not observe a chronic medical condition documented on child applications, medical action plan attached to applications, or orders from a health care professional documenting a chronic medical condition and specifying strict feeding instructions. I interviewed four staff members. Staff members stated that they follow the individual feeding plans for each infant age child. Staff members stated that they had not received instructions in writing or verbally requesting that any infant age child be awakened from nap to offer food on a strict schedule. Staff members stated that when children began eating baby food and/or table food, the child was served baby food and/or table food according to the schedule meals were served from the kitchen and bottles were still fed according to the individual feeding plan instructions. Staff members stated the frequency of the bottle feedings may be adjusted to avoid overfeeding the child. For example, if the individual feeding plan indicated that the child should be fed a bottle every three to four hours and the child had their last bottle at 6am and baby food for breakfast at 8:00am, the child would be offered the bottle closer to 10:00am stretching the three to four hours but staying within the feeding plan instructions. Staff members stated if a child missed a feeding of baby food due to an appointment, etc., the child was served baby food upon returning to the classroom unless the responsible adult had fed the child before returning the child to the classroom. Staff members stated if a child missed a feeding of table food due to an appointment, etc., the table food meal was stored appropriately in the kitchen until the child returned to the classroom and the kitchen staff would prepare the table food meal in the kitchen and deliver it to the classroom for the child to eat. Based on interviews with staff, review of children’s records for infant age children including individual feeding plans, and my observations, the allegation of violations of child care requirements regarding nutrition was not confirmed. Therefore, the allegation was unsubstantiated. I investigated the allegation of violations of child care requirements regarding supervision. I visited Space 1 where a total of seven infant age children were enrolled and present today with two teachers supervising the group. The children were observed in the classroom. I visited Space 2 where a total of eleven one- and two-year-old children were enrolled and present today with two teachers supervising the group. The children were observed in the classroom. I visited Space 3 where a total of twelve one- and two-year-old children were enrolled and present today with two teachers supervising the group. Three one-year-old children were observed playing on Outdoor Space 1 with one caregiver moving around the playground supervising the group. Nine two-year-old children were observed playing on Outdoor Space 2 with one caregiver moving around the playground supervising the group. I visited Outdoor Space 2 where children enrolled in Space 3, Space 4, and Space 5 were supervised by five teachers. Three groups/classrooms from Space 3, 4, and 5 were playing together on Outdoor Space 2 with five teachers supervising children ranging from two-years to four-years in age. Children were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, in the mulch area, and under the fire escape stairs. One teacher from Space 3 was moving around the playground supervising the children enrolled in Space 3. Two teachers from Space 4 and two teachers from Space 5 were standing in a row on the green artificial turf area approximately six feet apart from each other. These four teachers would turn their bodies to visually supervise the children and redirect children across the playground verbally from their spots on the green artificial turf area. In Space 4, a total of sixteen two- and three-year-old children were enrolled and fourteen two- and three-year-old children were present today with two teachers supervising the group. In Space 5, a total of ten three- and four-year-old children were enrolled and nine three- and four-year-old children were present today with two teachers supervising the group. In Space 6, a total of fourteen four- and five-year-old children were enrolled and twelve four- and five-year-old children were present today with two teachers supervising the group. I observed no staff members using personal cell phones indoors or outdoors when they should be actively supervising the children. I interviewed thirteen staff members. Staff members stated that staff do not use their personal cell phones while supervising children in the classrooms or on the playgrounds. Staff members stated that they have no concerns regarding other staff members using personal cell phones when they should be supervising children. While viewing live camera footage, I observed the two teachers from Space 4 move from their spots when they gathered their children to go indoors at the same time the group from Space 6 entered Outdoor Space 2. Two teachers from Space 5 were standing approximately six feet from each other on the green artificial turf area. One teacher from Space 6 was standing between the stationary composite piece and the man-made hill slide area. The second teacher from Space 6 was out of camera view which indicated she was too was positioned on the green artificial turf area closer to the wall because all other areas of the playground were in view of the camera except for the area behind the man-made hill slide area and I did not observe this teacher walk to that area. Children from Space 5 and 6 were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, and in the mulch area. During today’s visit, I observed children enrolled and present in Spaces 1 and 2 adequately supervised in classrooms. I observed children enrolled and present in Space 3 adequately supervised on the playground. Based on interviews with staff and my observations, the allegation of violations of child care requirements regarding supervision was not confirmed. Therefore, the allegation is unsubstantiated. However, based on my observations today, a violation related to supervision but unrelated to the allegation was cited and technical assistance was provided. Staff-child ratios, adequate space capacity, and approved space use were maintained during today’s visit. The facility permit was posted, and permit restrictions were maintained during today’s visit. The following violations were observed and cited during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. While on Outdoor Space 2, five teachers from Spaces 4, 5, and 6 did not adequately supervise children ranging in age from two-years to five-years. .1801(a)(1-5) 424 For children under two years of age, individualized caregiving routines such as eating, napping and toileting was not interspersed among the daily events. In the classroom for infant age care, naps were offered according to a scheduled morning naptime from 10:00am to 12:00pm and an afternoon naptime from 2:30pm to 3:30pm. Upon waking from sleep during the scheduled naptimes, infant age children were left in their cribs to self-soothe while other infant age children slept. .0508( e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .1801(a)(1-5), children should be adequately supervised at all times in child care centers. As stated in child care rule, adequate supervision means that: (1) staff are positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff interact with the children while moving about the indoor or outdoor area; (3) staff know where each child is located and are aware of the children's activities at all times; (4) staff provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff are able to see and hear children aged birth to five years old while the children are eating. Today, while monitoring outdoors, I observed three groups/classrooms from Space 3, 4, and 5 playing together on Outdoor Space 2 with five teachers supervising children ranging from two-years to four-years in age. Children were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, in the mulch area, and under the fire escape stairs. One teacher from Space 3 was moving around the playground supervising the children enrolled in Space 3. Two teachers from Space 4 and two teachers from Space 5 were standing in a row on the green artificial turf area approximately six feet apart from each other. These four teachers would turn their bodies to visually supervise the children and redirect children across the playground verbally from their spots on the green artificial turf area. While viewing camera footage, I observed the two teachers in Space 4 move from their spots when they gathered their children to go indoors at the same time the group from Space 6 entered Outdoor Space 2. Two teachers from Space 5 were standing approximately six feet from each other on the green artificial turf area. One teacher from Space 6 was standing between the stationary composite piece and the man-made hill slide area. The second teacher from Space 6 was out of camera view which indicated she was too was positioned on the green artificial turf area closer to the wall because all other areas of the playground were in view of the camera except for the area behind the man-made hill slide area and I did not observe this teacher walk to that area. Children from Space 5 and 6 were playing in the grass area, on the stationary composite piece, on the man-made hill slide area, and in the mulch area. To maintain compliance with this child care requirement, I advised you to encourage teachers to share supervision responsibilities when multiple groups of children were on the playground at the same time. I suggested you train teachers to separate themselves into four main areas/zones of the playgrounds and walk around interacting with the children within those four main areas/zones. I advised you to consider providing a supervision training opportunity for your staff and hold a staff meeting after the training to review your facility’s supervision policy and expectations. 2. Per child care rule 10A NCAC 09 .0508(e), for children under two years of age, individualized caregiving routines such as eating, napping and toileting should be interspersed among the daily events. During today’s visit, I observed the infant daily classroom schedule included a morning nap from 10:00am to 12:00pm and an afternoon nap from 2:30pm to 3:30pm. I observed infant age children asleep in cribs during the 10:00am to 12:00pm time period and between the 2:30pm to 3:30pm time period. During today’s visit, staff stated that the infant daily classroom schedule included two naptime routines for the infant age children. Staff stated that as part of the naptime routine, teachers ensured each child was fed and diapered before laying each infant age child down in their crib. Staff stated that each child was transferred to their crib with the expectation that each infant age child would self-soothe and fall asleep. Staff stated that when an infant age child awakes from their nap or does not fall asleep, the child is allowed to lie in their crib and self-soothe quietly as long as other children are asleep in the room and the awake child does not need to be fed or diapered. Staff stated that on the visual sleep check records, the first documented time indicated the time that the infant age child fell asleep. Staff stated that they do not record the time or position that the child was laid down in the crib but do record the child’s sleep position and time that the child falls asleep. After reviewing visual sleep check records, I was able to confirm the staff’s statements. As discussed today, while including naptime routines, feeding routines, and diapering routines in an infant daily schedule is a common and accepted practice, expecting all infant age children to adhere to this schedule is not acceptable. Child care rule requires each infant age child to be fed, diapered, and allowed to sleep as needed according to each infant age child’s individual needs and wants. Child care rule requires teachers to interact with children during their waking hours. Just as each infant age child gives cues to alert the teacher that they are hungry, infant age children will also give cues that they are sleepy, bored, and uncomfortable. Teachers providing infant age care should use each infant’s cues to provide the individualized care that each child needs. As discussed today, when an infant age child is awake and other children in the classroom are asleep, that is a good time for the child to be taken from the crib and provided supervised tummy-time, outdoor time, or other individualized planned activities documented on the activity plan. To maintain compliance with this child care requirement, I suggest you review child care rule section 10A NCAC 09 .0508 Activity Schedules And Plans and section 10A NCAC 09 .0511 Daily Routines For Children Under Two Years Of Age with all staff that may regularly work in the classroom with infant age children or may be asked to work in the classroom with infant age children from time to time. I also suggested you revise the infant daily classroom schedule to include a clause the states the following, “While this schedule includes all the activities we will offer your child throughout the day, the times will vary based on the individual needs of each infant age child and will documented in each child’s daily ‘Bright Wheel’ report.” Lastly, I suggested you use the “Infant Sleep Chart” sample provided on the DCDEE website under “Provider Documents and Forms”. This document will allow teachers space to document the date, time, and position of each child when the child is laid down in the crib, as well as the time and position when the child goes to sleep. CONSULTATION: 1. During today’s visit, I observed the classroom for infant age children darkened by a room-darkening shade covering the only oversized window at the back of the room and the classroom lights turned off. I observed a privacy glass window in the classroom door which provided the only light entering the room from the florescent lighting in the hallway. It took my eyes several minutes to adjust to the lack of light and feel safe to move about the classroom without injury. I had to walk to the classroom door to see and write my notes. As discussed today, when the classroom is this dark, it is too dark and an unsafe environment for staff and visitors. I suggest you increase the amount of light in the classroom when the infant age children are asleep either by slightly raising the room-darkening shade or by placing a small table lamp with a low wattage bulb on top of the refrigerator with the cord hidden behind the refrigerator or on the counter at the food preparation area with the cord unreachable by the infant age children. 2. During today’s visit, I also observed instrumental music playing in the classroom for infant age children at a volume that made it difficult for me to hear the teachers when I spoke with them. When the music is this loud, it is too loud and an unsafe environment for children and staff. I suggest you decrease the volume of the music to allow staff to speak each other at a normal volume and hear each other and an emergency alerts that may be made by the administrative staff. 3. Per child care rule 10A NCAC 09 .0508(c), for children under 2 years of age, a minimum of thirty minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity should be provided weather permitting. During today’s visit, I observed the infant daily classroom schedule included outdoor time from 1:00pm to 1:30pm. At 1:13pm, I entered the classroom for infant age children and asked the teachers when the children would taken outside today. One teacher stated that infant age children are not always taken outside every day because the feeding, diapering, and napping schedules do not always allow for outside time. As explained today, child care rule requires a total of thirty minutes of outside time throughout the caregiving day and can be provided by one teacher staying in the classroom and the second teacher taking individual children or small groups of infant age children at similar development levels to the infant/toddler playground, by a teacher assistant coming in the classroom to assist with routine care while a teacher takes children outside, or by a teacher assistant coming in the classroom and taking children outside. 4. As discussed today, the original copy of the “Individual Feeding Plan” should be placed in each infant child’s record file when the child leaves the facility or when the child reaches fifteen months of age. Best practice is to keep each child’s “Individual Feeding Plan” on file with all other child record documents as long as the child is enrolled in the facility and for at least one year after the child is no longer enrolled in the facility. 5. As discussed, one violation cited during today’s visit will require a follow-up visit within two weeks. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than May 21, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. A computer-generated visit summary was prepared and a printed copy will be shared with you during the required follow-up visit. We appreciate all you and your staff are doing to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0606 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/6/2025 Number Present: 44 Completed Date: 2/6/2025 Age: From 0 To 5 Total Minutes: 345 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 03:45 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. Susan Rowe, Assistant Director, assisted us with today’s visit. Cassidy Dale, Administrator, was not available today. Deborah Howell, Child Care Consultant, assisted me with today’s visit. I conducted your last annual compliance visit on February 21, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, Inc., that owns your facility. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Young Men's Christian Association Of Catawba Valley, Inc., the corporation that owns your facility, was reviewed and listed as current-active on the North Carolina Secretary of State website February 3, 2025. Your program’s compliance history was 86% as of February 5, 2025 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting staff benefits package and infrastructure for parent involvement. Your last sanitation inspection was dated December 18, 2024 with a Superior classification and two demerits. I verified that on February 12, 2024, you received lead water testing results that are required to be completed every three years. Today, I verified that those test results indicate that the facility’s water is within acceptable limits. I verified that you have completed the enrollment for the required lead-based paint testing and the required asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024. I visited each licensed indoor and outdoor space with you today. Children were playing in activity areas and outside. You stated and I verified that your facility uses Explorations for Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Meals were prepared in the kitchen and served in the classrooms. Today’s lunch included hamburger patty, tater tots, pineapple, bun or wheat bread, and unflavored milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 32 degrees Fahrenheit. Infant bottles and infant food were stored in a full-size refrigerator at 40 degrees Fahrenheit in Space 1. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. Your written operational, administrative, and personnel policies and your parent participation plan were reviewed during a routine unannounced visit on August 14, 2024. Today, you stated that your written polices and parent participation plan had not changed. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were observed and cited during today's visit: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 2 the rugs were visibly soiled and need to be cleaned or replaced. In Space 3 the walls were visibly soiled and need to be cleaned or painted. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. In Space 2, pillow covers, dramatic play set, and the changing table were visibly soiled. In Space 3, the dramatic play set, toy shelves, pillow covers and step stool were visibly soiled. In Space 4, the step stool, changing table and dramatic play sink were visibly soiled. In Space 5, the trashcan, dramatic play sink and three drawer cart were visibly soiled. In Space 6, the pillow covers and the dramatic play sink were visibly soiled. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. The door to the kitchen was left open and unlocked without anyone in the space. There were kitchen items and materials which are hazardous and should not be accessible to children. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 6, a bottle of disinfecting spray was stored below five feet. .2820(b) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. In Space 1, the center's Safe Sleep Policy was not posted in the classroom. .0606(b) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A file for one child did not contain documentation of a required medical exam. GS110-91(1) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy acknowledgement statement for two children did not include the date of enrollment as required. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space 1, a permission to administer form for an over the counter (OTC) medication did not indicate in which manner the medication was to be applied. In Space 2, a permission to administer form for an OTC medication did not indicate the amount of medication to be used. In Space 4, there was not a permission to administer form to apply petroleum jelly. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. I also suggest you do not accept any medication that is not accompanied by a completed permission to administer form. 2. Per sanitation rule 15A NCAC 18A .2825(a), walls, floors, and rugs should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you wash the walls when soiled and shampoo the rugs and carpets at least every six months. I also suggest you train staff to use water and soapy water to spot clean rugs and carpets in between shampooing. 3. Per child care rule 10A NCAC 09. 0601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you clean furniture and equipment including pillow covers, dramatic play sets and clothing, toy shelves, diaper changing tables, trash cans, and step stools when they are visibly soiled rather than on a cleaning schedule routine. 4. Per child care rule 10A NCAC 09 .0606(b), the center's safe sleep policy should be posted in a prominent place in the infant room where parents and caregivers were able to view daily. Today, the center’s safe sleep policy was not posted in Space 1 where infant care is provided. Teachers stated that the postings including the center’s safe sleep policy had been removed from the bathroom door in January when the door was refinished and the safe sleep policy had been overlooked when the postings were returned to the bathroom door. Today, you printed and posted a copy of the center’s safe sleep policy in the classroom on the bathroom door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create a checklist that includes all the required postings for each classroom and give this to the staff so they can have a list of the postings they should maintain in their classroom. 5. Per sanitation for child care rule 15A NCAC 18A.2820(b), disinfecting and sanitizing spray mixed at the facility on a daily basis may be stored unlocked in the classroom as long it is stored above five feet. Today, in Space 6, the disinfecting spray bottle was sitting on a shelf below five feet. The teacher moved the disinfecting spray bottle above five feet by placing it on top of a metal storage cabinet in the classroom which corrected this violation. To maintain compliance with this sanitation requirement, I suggest you review this sanitation rule with your staff. 6. Each discipline policy acknowledgement statement signed and dated by the parent should include the child’s name and date of enrollment. Today, two discipline policy acknowledgement statements in child record files did not have the date of enrollment recorded on the discipline policy acknowledgement statement document. You wrote in the enrollment date for each child which corrected this violation. To maintain compliance with this child care requirement, I suggest you carefully review all enrollment documents and record the enrollment date on the documents as required. 7. Per NC General Statute 110-91(1), each child should have a children’s medical report on file on or before the child’s first day of attendance but no later than 30 days after enrollment. To maintain compliance with this child care requirement, you should require each parent to complete Section A and have their health care professional complete Section B of the “Children’s Medical Report” document provided by DCDEE and submit the completed document to you within the child’s first thirty days of enrollment. I suggest you develop a tracking tool or system to assist you in keeping up with those due dates. 8. Per child care rule 10A NCAC 09 .0601(a), a safe indoor and outdoor environment should be provided for the children. Today, the kitchen door was left open and unlocked while the kitchen was unattended. Today, I reminded the kitchen staff and you that the kitchen door must be closed and locked when no one was in the kitchen. You closed and locked the kitchen door which corrected this violation. To maintain compliance with this child care requirement, I suggest you create and post a sign on the kitchen door that reminds staff to close and lock the door when no one is in the kitchen. CONSULTATION: 1. Upon arrival, I noticed a sign on the entrance door informing parents of a “Parent’s Night Out” on Friday, February 14, 2025 from 6:30pm to 8:30pm. As discussed today, the child care law and rules do not address events planned after a facility’s hours of operation. However, any care provided in the licensed facility, regardless of the time it’s provided, would need to follow all applicable child care rules. The only exception to this would be an after hour event such as a festival or graduation, where the families are present and responsible for their children. If after hour activities are planned, I encourage you to contact me to answer questions and/or provide technical assistance to help with planning and ensuring compliance with applicable requirements. 2. As discussed today, per child care rule 10A NCAC 09 .0605(a), outdoor play equipment should be age and developmentally appropriate. Today, I reminded you and staff that the stationary climbing piece on Outdoor Space 1 was intended by the manufacturer to be used by children six to twenty-three months of age. Today, I observed one classroom with one-year and two-year old children enrolled. To maintain compliance with this child care requirement and to maintain compliance with the manufacturers intended age use, you stated children two years of age would use Outdoor Space 2 where the stationary equipment was intended to be used by children two to twelve years of age and the children one year of age would use the equipment on Outdoor Space 1. 3. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. 4. The new QRIS Modernization Plan known as “Pathways to Success” is being added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission will continue the rulemaking process to add the rule language to child care requirements. This process with take several months. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Star rated license assessments are still required for new child care programs. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. Please be reminded any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. 5. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. Here are some important links on the DCEEE website that may be helpful: Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New COMPLIANCE PLAN: No compliance documentation is needed for violation item numbers 840 and 892 corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Your signature I must receive your compliance letter no later than February 20, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/21/2024 Number Present: 67 Completed Date: 8/21/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 09:02 AM Time Out: 12:10 PM Time In: 01:08 PM Time Out: 04:05 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Cassidy Dale, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on February 15, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Young Men's Christian Association Of Catawba Valley was reviewed and listed as current- active on the NC Secretary of State website on August 19, 2024. Your program’s compliance history was 87% as of August 19, 2024 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your last sanitation inspection was dated May 23, 2024 with a Superior classification and six demerits. I verified that you have completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicated that your facilities drinking water source was within the required limits. I verified that you have registered for the lead paint/asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024 after I requested you send me updated report by email. You and I visited each licensed indoor space and outdoor space today. I observed infant and one-year-old children engaged in floor play and routine care. I observed one-year-old children engaged in free play throughout the room. I observed two-year-old and three-year-old children transitioning from indoor play to outdoor play. I observed four-year-old children playing outside. I observed four-year and five-year-old children participating in a teacher-lead whole group language activity. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 34 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 41 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for four new staff members hired since the last annual compliance visit on February 15, 2024. I monitored health and safety requirements. You stated your facility uses the same employee and parent handbooks as O.L. Moretz Foundation YMCA Early Learning Center which is owned and operated by the same corporation. In February 2023, I reviewed your written operational, administrative, and personnel policies and your parent participation plan at a routine unannounced visit at O.L. Moretz Foundation YMCA Early Learning Center. On July 31, 2024 at an annual compliance visit at O.L. Moretz Foundation YMCA Early Learning Center, I reviewed the updated Parent Handbook which contained the operational policies and parent participation plan shared by your facility. You stated the administrative and personnel policies had not been updated since February 2023. I observed all the required components included in these written policies. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: 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 fire inspection report dated May 1, 2024 was received on May 31, 2024 by email per consultant request. 10A NCAC 09 .0304(a) 604 Lavatories were not kept clean, in good repair and kept free of storage. In Space 2, the trash can lid was visibly soiled. In Space 4, the handwashing sink was visibly soiled and the faucet fixture was corroded and beginning to rust. 15A NCAC 18A .2818(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 3, the wall by the handwashing sink was visibly soiled. In Space 4, the wall by the handwashing sink was visibly soiled, the paint was peeling in spots on the cinderblock wall, and the drywall was scarred and/or the paint was chipping in several spots. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. The finish on some furnishings including toy shelving and a child-size table and chair was worn off the wood and needed to be replaced or refinished. In Space 3, three toy shelves need to be replaced or refinished. In Space 4, 1 toy shelf needs to be replaced or refinished. In Space 5, one toy shelf, one child-size table and one child-size chair in the dramatic play area needs to be replaced or refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, the permission to administer forms for two non-prescription diaper ointments were missing required information. In Space 2, the permission to administer form for one non-prescription diaper ointment and one sunscreen were missing the amount to be applied. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer authorization for one non-presciption diaper ointment had expired and the medication had not been returned to the parent within 72 hours. In Space 3, the permission to administer authorization for four non-prescription diaper ointments had expired and the medications had not been returned to the parent within 72 hours. In Space 3, six non-presciption medications had expired and the medications had not been returned to the parent within 72 hours. .0803(12) 1041 Prior to employment a Criminal Background Check was not completed. One employee with a date of employment of 03/18/2024 who signed policy acknowlegdement statements on 03/08/2024 had a CBC qualification letter dated 03/15/2024. One employee with a date of employment of 07/29/2024 who signed policy acknowledgement statements on 07/15/2024 had a CBC qualification letter dated 07/18/2024. One employee with a date of employment of 08/05/2024 who signed policy acknowledgement statements on 07/17/2024 had a CBC qualification letter dated 07/19/2024. G.S. 110-90.2(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR Plan dated May 24, 2023 was not updated annually. .0607(e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. Prior to today’s visit, I received your fire inspection report dated May 1, 2024 on May 31, 2024 after I sent you an email reminder that your fire inspection was due. A violation was cited because the fire inspection report was not received within one week of its completion date. Because I received the violation prior to today’s visit, the violation was recorded as corrected during today’s visit. To maintain compliance with this child care requirement, I suggest you forward the email containing the fire inspection report when you receive it from the fire inspector. 2. Per sanitation rule 15A NCAC 18A .2818(a), lavatories including sinks should be kept clean, in good repair, and kept free of storage. To maintain compliance this sanitation rule, I suggest you have your staff deep clean the handwashing sinks and then wipe them clean daily. I also suggest you replace any faucets that are corroding and beginning to rust. 3. Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you touch up the peeling paint on the cinderblock walls and repair any wall scars and chipping paint on the drywall. 4. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 5. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. 6. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within 72 hours. To maintain compliance with this child care requirement, I suggest you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. 7. Per NC General Statute 110-90.2(b), each employee should have a Criminal Background Check (CBC) qualification letter on file prior to employment. As discussed today, employee’s may not complete any “onboarding procedures for new employees” prior to your receiving a CBC qualification letter. Completing “onboarding procedures for new employees” shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. New employees that come to you with a valid and current CBC qualification letter in hand may begin “onboarding procedures for new employees” as you wish. To maintain compliance with this child requirement, I suggest you speak with the human resource department for your organization and revise your “onboarding procedures for new employees” that are waiting to receive their CBC qualification letter. 8. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. An updated EPR Plan should be printed each and any time the EPR Plan is updated for any reason. To maintain compliance with child requirement, I suggest you contact the web portal for assistance in transferring this facility’s EPR Plan from the previous administrator to the current administrator. CONSULTATION: 1. Per sanitation rule 15A NCAC 18A.2832(a), the outdoor child care center premises, including the outdoor learning environment, should be kept drained to minimize standing water. As discussed today, your maintenance department should continue to explore solutions to the two areas on the Outdoor Play Space 2 where water has been pooling during heavy rain events. 2. Stackable cots should be stored in a way that prevents the top cot from being contaminated by children during play and classroom use. I suggested you place an extra unassigned cot on top of each stack of cots to prevent contamination in your classrooms where children two and under are enrolled and drape a vinyl tablecloth over each stack of cots in the classrooms where children three and older are enrolled. 3. When deciding the due date for the on-going training hours for your staff, you’ll have to look at each staff member and determine the due date for completion as follows: a) If the staff member had completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member will have until the next annual compliance date to complete the next annual requirement of on-going training hours. b) If the staff member had not completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member would be given until the annual compliance anniversary date to complete the on-going training requirement. c) If the staff member was newly hired since the last annual compliance visit, their on-going training hours would not be monitored the first year of employment with the assumption that they’ll complete the first-year training requirements for health & safety and other trainings which will account for the required number of hours. d) If the staff member was hired in 2024, their on-going training hours are required to be completed by their 2nd year employment anniversary and will be monitored at the next ACV. 4. As discussed today, when a violation is cited due to an issue in one specific classroom, staff file, or child file, best practice is to correct the violation in all the classrooms, all the staff files, and all the child files which also minimizes the risk of a repeat violation. Repeat violations could result in an administrative action due to a pattern of non-compliance. 5. Please post adult handwashing procedures at the handwashing sinks used by adults. 6. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 7. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 8. On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. 9. From 02/07/2024 to 05/23/2024, there was a series of email and phone call exchanges between Paxton Tallent, Executive Director of Services, at Hickory Foundation YMCA, and me regarding a request to operate unlicensed school-age child care for the summer months and throughout the school year. As a result of these conversations, expectations and requirements were shared with the Mr. Tallent and Nat Auten, CEO of Young Men’s Christian Association of Catawba Valley, the corporation that owns Hickory Foundation YMCA Child Development Center. On May 22, 2024, I requested a written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 24, 2024, I received the written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 28, 2024, I notified Mr. Tallent and Mr. Auten the response from DCDEE upper management regarding their written plan as follows: Your written plan for summer operation from May 28, 2024 through August 23, 2024 has been approved. Per your request, effective May 24, 2024, the age range on your license will be changed from 0 – 12 years to 0 -5 years. Please keep your current license posted in the Hickory Foundation YMCA Child Development Center until a new license/permit is processed and mailed to you. Per your request, the gymnasium and all other licensed spaces in the Teen Center building will be removed from the licensed program with plans to return the gymnasium to licensed space after August 23, 2024. We are waiting for further clarification and verification regarding the previously shared information that building, fire, and/or sanitation inspections would not be required when the gym is added back as licensed space for the licensed program at the end of the requested unlicensed period. I will pass along clarifying information as soon as I receive it. If DCDEE upper management determines, that building, fire, and/or sanitation inspections are required when you add the gym back to the licensed space, the Off-Premise Activity Permission Forms may continue to be used for the children enrolled in the licensed program to be able to continue to use the unlicensed gym. Please respond to this email to verify that you received this information and understand the approved terms for operating both a licensed and unlicensed program at the Hickory Foundation YMCA site. On May 28, 2024, I received an email response from Mr. Tallent that included an acknowledgement statement and a request for additional information regarding the use of the gymnasium after the summer. The response was as follows: We have received and acknowledge the requirements to operate licensed and unlicensed programming on the Hickory Foundation YMCA campus and will await further direction regarding usage of the gymnasium after the summer. COMPLIANCE PLAN: No compliance documentation is needed for violation item number 106 which was corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 4, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit , a visit summary was prepared, printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0607 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/21/2024 Number Present: 67 Completed Date: 8/21/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 09:02 AM Time Out: 12:10 PM Time In: 01:08 PM Time Out: 04:05 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Cassidy Dale, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on February 15, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Young Men's Christian Association Of Catawba Valley was reviewed and listed as current- active on the NC Secretary of State website on August 19, 2024. Your program’s compliance history was 87% as of August 19, 2024 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your last sanitation inspection was dated May 23, 2024 with a Superior classification and six demerits. I verified that you have completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicated that your facilities drinking water source was within the required limits. I verified that you have registered for the lead paint/asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024 after I requested you send me updated report by email. You and I visited each licensed indoor space and outdoor space today. I observed infant and one-year-old children engaged in floor play and routine care. I observed one-year-old children engaged in free play throughout the room. I observed two-year-old and three-year-old children transitioning from indoor play to outdoor play. I observed four-year-old children playing outside. I observed four-year and five-year-old children participating in a teacher-lead whole group language activity. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 34 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 41 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for four new staff members hired since the last annual compliance visit on February 15, 2024. I monitored health and safety requirements. You stated your facility uses the same employee and parent handbooks as O.L. Moretz Foundation YMCA Early Learning Center which is owned and operated by the same corporation. In February 2023, I reviewed your written operational, administrative, and personnel policies and your parent participation plan at a routine unannounced visit at O.L. Moretz Foundation YMCA Early Learning Center. On July 31, 2024 at an annual compliance visit at O.L. Moretz Foundation YMCA Early Learning Center, I reviewed the updated Parent Handbook which contained the operational policies and parent participation plan shared by your facility. You stated the administrative and personnel policies had not been updated since February 2023. I observed all the required components included in these written policies. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: 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 fire inspection report dated May 1, 2024 was received on May 31, 2024 by email per consultant request. 10A NCAC 09 .0304(a) 604 Lavatories were not kept clean, in good repair and kept free of storage. In Space 2, the trash can lid was visibly soiled. In Space 4, the handwashing sink was visibly soiled and the faucet fixture was corroded and beginning to rust. 15A NCAC 18A .2818(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 3, the wall by the handwashing sink was visibly soiled. In Space 4, the wall by the handwashing sink was visibly soiled, the paint was peeling in spots on the cinderblock wall, and the drywall was scarred and/or the paint was chipping in several spots. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. The finish on some furnishings including toy shelving and a child-size table and chair was worn off the wood and needed to be replaced or refinished. In Space 3, three toy shelves need to be replaced or refinished. In Space 4, 1 toy shelf needs to be replaced or refinished. In Space 5, one toy shelf, one child-size table and one child-size chair in the dramatic play area needs to be replaced or refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, the permission to administer forms for two non-prescription diaper ointments were missing required information. In Space 2, the permission to administer form for one non-prescription diaper ointment and one sunscreen were missing the amount to be applied. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer authorization for one non-presciption diaper ointment had expired and the medication had not been returned to the parent within 72 hours. In Space 3, the permission to administer authorization for four non-prescription diaper ointments had expired and the medications had not been returned to the parent within 72 hours. In Space 3, six non-presciption medications had expired and the medications had not been returned to the parent within 72 hours. .0803(12) 1041 Prior to employment a Criminal Background Check was not completed. One employee with a date of employment of 03/18/2024 who signed policy acknowlegdement statements on 03/08/2024 had a CBC qualification letter dated 03/15/2024. One employee with a date of employment of 07/29/2024 who signed policy acknowledgement statements on 07/15/2024 had a CBC qualification letter dated 07/18/2024. One employee with a date of employment of 08/05/2024 who signed policy acknowledgement statements on 07/17/2024 had a CBC qualification letter dated 07/19/2024. G.S. 110-90.2(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR Plan dated May 24, 2023 was not updated annually. .0607(e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. Prior to today’s visit, I received your fire inspection report dated May 1, 2024 on May 31, 2024 after I sent you an email reminder that your fire inspection was due. A violation was cited because the fire inspection report was not received within one week of its completion date. Because I received the violation prior to today’s visit, the violation was recorded as corrected during today’s visit. To maintain compliance with this child care requirement, I suggest you forward the email containing the fire inspection report when you receive it from the fire inspector. 2. Per sanitation rule 15A NCAC 18A .2818(a), lavatories including sinks should be kept clean, in good repair, and kept free of storage. To maintain compliance this sanitation rule, I suggest you have your staff deep clean the handwashing sinks and then wipe them clean daily. I also suggest you replace any faucets that are corroding and beginning to rust. 3. Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you touch up the peeling paint on the cinderblock walls and repair any wall scars and chipping paint on the drywall. 4. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 5. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. 6. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within 72 hours. To maintain compliance with this child care requirement, I suggest you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. 7. Per NC General Statute 110-90.2(b), each employee should have a Criminal Background Check (CBC) qualification letter on file prior to employment. As discussed today, employee’s may not complete any “onboarding procedures for new employees” prior to your receiving a CBC qualification letter. Completing “onboarding procedures for new employees” shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. New employees that come to you with a valid and current CBC qualification letter in hand may begin “onboarding procedures for new employees” as you wish. To maintain compliance with this child requirement, I suggest you speak with the human resource department for your organization and revise your “onboarding procedures for new employees” that are waiting to receive their CBC qualification letter. 8. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. An updated EPR Plan should be printed each and any time the EPR Plan is updated for any reason. To maintain compliance with child requirement, I suggest you contact the web portal for assistance in transferring this facility’s EPR Plan from the previous administrator to the current administrator. CONSULTATION: 1. Per sanitation rule 15A NCAC 18A.2832(a), the outdoor child care center premises, including the outdoor learning environment, should be kept drained to minimize standing water. As discussed today, your maintenance department should continue to explore solutions to the two areas on the Outdoor Play Space 2 where water has been pooling during heavy rain events. 2. Stackable cots should be stored in a way that prevents the top cot from being contaminated by children during play and classroom use. I suggested you place an extra unassigned cot on top of each stack of cots to prevent contamination in your classrooms where children two and under are enrolled and drape a vinyl tablecloth over each stack of cots in the classrooms where children three and older are enrolled. 3. When deciding the due date for the on-going training hours for your staff, you’ll have to look at each staff member and determine the due date for completion as follows: a) If the staff member had completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member will have until the next annual compliance date to complete the next annual requirement of on-going training hours. b) If the staff member had not completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member would be given until the annual compliance anniversary date to complete the on-going training requirement. c) If the staff member was newly hired since the last annual compliance visit, their on-going training hours would not be monitored the first year of employment with the assumption that they’ll complete the first-year training requirements for health & safety and other trainings which will account for the required number of hours. d) If the staff member was hired in 2024, their on-going training hours are required to be completed by their 2nd year employment anniversary and will be monitored at the next ACV. 4. As discussed today, when a violation is cited due to an issue in one specific classroom, staff file, or child file, best practice is to correct the violation in all the classrooms, all the staff files, and all the child files which also minimizes the risk of a repeat violation. Repeat violations could result in an administrative action due to a pattern of non-compliance. 5. Please post adult handwashing procedures at the handwashing sinks used by adults. 6. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 7. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 8. On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. 9. From 02/07/2024 to 05/23/2024, there was a series of email and phone call exchanges between Paxton Tallent, Executive Director of Services, at Hickory Foundation YMCA, and me regarding a request to operate unlicensed school-age child care for the summer months and throughout the school year. As a result of these conversations, expectations and requirements were shared with the Mr. Tallent and Nat Auten, CEO of Young Men’s Christian Association of Catawba Valley, the corporation that owns Hickory Foundation YMCA Child Development Center. On May 22, 2024, I requested a written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 24, 2024, I received the written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 28, 2024, I notified Mr. Tallent and Mr. Auten the response from DCDEE upper management regarding their written plan as follows: Your written plan for summer operation from May 28, 2024 through August 23, 2024 has been approved. Per your request, effective May 24, 2024, the age range on your license will be changed from 0 – 12 years to 0 -5 years. Please keep your current license posted in the Hickory Foundation YMCA Child Development Center until a new license/permit is processed and mailed to you. Per your request, the gymnasium and all other licensed spaces in the Teen Center building will be removed from the licensed program with plans to return the gymnasium to licensed space after August 23, 2024. We are waiting for further clarification and verification regarding the previously shared information that building, fire, and/or sanitation inspections would not be required when the gym is added back as licensed space for the licensed program at the end of the requested unlicensed period. I will pass along clarifying information as soon as I receive it. If DCDEE upper management determines, that building, fire, and/or sanitation inspections are required when you add the gym back to the licensed space, the Off-Premise Activity Permission Forms may continue to be used for the children enrolled in the licensed program to be able to continue to use the unlicensed gym. Please respond to this email to verify that you received this information and understand the approved terms for operating both a licensed and unlicensed program at the Hickory Foundation YMCA site. On May 28, 2024, I received an email response from Mr. Tallent that included an acknowledgement statement and a request for additional information regarding the use of the gymnasium after the summer. The response was as follows: We have received and acknowledge the requirements to operate licensed and unlicensed programming on the Hickory Foundation YMCA campus and will await further direction regarding usage of the gymnasium after the summer. COMPLIANCE PLAN: No compliance documentation is needed for violation item number 106 which was corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 4, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit , a visit summary was prepared, printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/21/2024 Number Present: 67 Completed Date: 8/21/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 09:02 AM Time Out: 12:10 PM Time In: 01:08 PM Time Out: 04:05 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Cassidy Dale, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on February 15, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Young Men's Christian Association Of Catawba Valley was reviewed and listed as current- active on the NC Secretary of State website on August 19, 2024. Your program’s compliance history was 87% as of August 19, 2024 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your last sanitation inspection was dated May 23, 2024 with a Superior classification and six demerits. I verified that you have completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicated that your facilities drinking water source was within the required limits. I verified that you have registered for the lead paint/asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024 after I requested you send me updated report by email. You and I visited each licensed indoor space and outdoor space today. I observed infant and one-year-old children engaged in floor play and routine care. I observed one-year-old children engaged in free play throughout the room. I observed two-year-old and three-year-old children transitioning from indoor play to outdoor play. I observed four-year-old children playing outside. I observed four-year and five-year-old children participating in a teacher-lead whole group language activity. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 34 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 41 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for four new staff members hired since the last annual compliance visit on February 15, 2024. I monitored health and safety requirements. You stated your facility uses the same employee and parent handbooks as O.L. Moretz Foundation YMCA Early Learning Center which is owned and operated by the same corporation. In February 2023, I reviewed your written operational, administrative, and personnel policies and your parent participation plan at a routine unannounced visit at O.L. Moretz Foundation YMCA Early Learning Center. On July 31, 2024 at an annual compliance visit at O.L. Moretz Foundation YMCA Early Learning Center, I reviewed the updated Parent Handbook which contained the operational policies and parent participation plan shared by your facility. You stated the administrative and personnel policies had not been updated since February 2023. I observed all the required components included in these written policies. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: 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 fire inspection report dated May 1, 2024 was received on May 31, 2024 by email per consultant request. 10A NCAC 09 .0304(a) 604 Lavatories were not kept clean, in good repair and kept free of storage. In Space 2, the trash can lid was visibly soiled. In Space 4, the handwashing sink was visibly soiled and the faucet fixture was corroded and beginning to rust. 15A NCAC 18A .2818(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 3, the wall by the handwashing sink was visibly soiled. In Space 4, the wall by the handwashing sink was visibly soiled, the paint was peeling in spots on the cinderblock wall, and the drywall was scarred and/or the paint was chipping in several spots. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. The finish on some furnishings including toy shelving and a child-size table and chair was worn off the wood and needed to be replaced or refinished. In Space 3, three toy shelves need to be replaced or refinished. In Space 4, 1 toy shelf needs to be replaced or refinished. In Space 5, one toy shelf, one child-size table and one child-size chair in the dramatic play area needs to be replaced or refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, the permission to administer forms for two non-prescription diaper ointments were missing required information. In Space 2, the permission to administer form for one non-prescription diaper ointment and one sunscreen were missing the amount to be applied. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer authorization for one non-presciption diaper ointment had expired and the medication had not been returned to the parent within 72 hours. In Space 3, the permission to administer authorization for four non-prescription diaper ointments had expired and the medications had not been returned to the parent within 72 hours. In Space 3, six non-presciption medications had expired and the medications had not been returned to the parent within 72 hours. .0803(12) 1041 Prior to employment a Criminal Background Check was not completed. One employee with a date of employment of 03/18/2024 who signed policy acknowlegdement statements on 03/08/2024 had a CBC qualification letter dated 03/15/2024. One employee with a date of employment of 07/29/2024 who signed policy acknowledgement statements on 07/15/2024 had a CBC qualification letter dated 07/18/2024. One employee with a date of employment of 08/05/2024 who signed policy acknowledgement statements on 07/17/2024 had a CBC qualification letter dated 07/19/2024. G.S. 110-90.2(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR Plan dated May 24, 2023 was not updated annually. .0607(e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. Prior to today’s visit, I received your fire inspection report dated May 1, 2024 on May 31, 2024 after I sent you an email reminder that your fire inspection was due. A violation was cited because the fire inspection report was not received within one week of its completion date. Because I received the violation prior to today’s visit, the violation was recorded as corrected during today’s visit. To maintain compliance with this child care requirement, I suggest you forward the email containing the fire inspection report when you receive it from the fire inspector. 2. Per sanitation rule 15A NCAC 18A .2818(a), lavatories including sinks should be kept clean, in good repair, and kept free of storage. To maintain compliance this sanitation rule, I suggest you have your staff deep clean the handwashing sinks and then wipe them clean daily. I also suggest you replace any faucets that are corroding and beginning to rust. 3. Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you touch up the peeling paint on the cinderblock walls and repair any wall scars and chipping paint on the drywall. 4. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 5. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. 6. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within 72 hours. To maintain compliance with this child care requirement, I suggest you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. 7. Per NC General Statute 110-90.2(b), each employee should have a Criminal Background Check (CBC) qualification letter on file prior to employment. As discussed today, employee’s may not complete any “onboarding procedures for new employees” prior to your receiving a CBC qualification letter. Completing “onboarding procedures for new employees” shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. New employees that come to you with a valid and current CBC qualification letter in hand may begin “onboarding procedures for new employees” as you wish. To maintain compliance with this child requirement, I suggest you speak with the human resource department for your organization and revise your “onboarding procedures for new employees” that are waiting to receive their CBC qualification letter. 8. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. An updated EPR Plan should be printed each and any time the EPR Plan is updated for any reason. To maintain compliance with child requirement, I suggest you contact the web portal for assistance in transferring this facility’s EPR Plan from the previous administrator to the current administrator. CONSULTATION: 1. Per sanitation rule 15A NCAC 18A.2832(a), the outdoor child care center premises, including the outdoor learning environment, should be kept drained to minimize standing water. As discussed today, your maintenance department should continue to explore solutions to the two areas on the Outdoor Play Space 2 where water has been pooling during heavy rain events. 2. Stackable cots should be stored in a way that prevents the top cot from being contaminated by children during play and classroom use. I suggested you place an extra unassigned cot on top of each stack of cots to prevent contamination in your classrooms where children two and under are enrolled and drape a vinyl tablecloth over each stack of cots in the classrooms where children three and older are enrolled. 3. When deciding the due date for the on-going training hours for your staff, you’ll have to look at each staff member and determine the due date for completion as follows: a) If the staff member had completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member will have until the next annual compliance date to complete the next annual requirement of on-going training hours. b) If the staff member had not completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member would be given until the annual compliance anniversary date to complete the on-going training requirement. c) If the staff member was newly hired since the last annual compliance visit, their on-going training hours would not be monitored the first year of employment with the assumption that they’ll complete the first-year training requirements for health & safety and other trainings which will account for the required number of hours. d) If the staff member was hired in 2024, their on-going training hours are required to be completed by their 2nd year employment anniversary and will be monitored at the next ACV. 4. As discussed today, when a violation is cited due to an issue in one specific classroom, staff file, or child file, best practice is to correct the violation in all the classrooms, all the staff files, and all the child files which also minimizes the risk of a repeat violation. Repeat violations could result in an administrative action due to a pattern of non-compliance. 5. Please post adult handwashing procedures at the handwashing sinks used by adults. 6. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 7. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 8. On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. 9. From 02/07/2024 to 05/23/2024, there was a series of email and phone call exchanges between Paxton Tallent, Executive Director of Services, at Hickory Foundation YMCA, and me regarding a request to operate unlicensed school-age child care for the summer months and throughout the school year. As a result of these conversations, expectations and requirements were shared with the Mr. Tallent and Nat Auten, CEO of Young Men’s Christian Association of Catawba Valley, the corporation that owns Hickory Foundation YMCA Child Development Center. On May 22, 2024, I requested a written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 24, 2024, I received the written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 28, 2024, I notified Mr. Tallent and Mr. Auten the response from DCDEE upper management regarding their written plan as follows: Your written plan for summer operation from May 28, 2024 through August 23, 2024 has been approved. Per your request, effective May 24, 2024, the age range on your license will be changed from 0 – 12 years to 0 -5 years. Please keep your current license posted in the Hickory Foundation YMCA Child Development Center until a new license/permit is processed and mailed to you. Per your request, the gymnasium and all other licensed spaces in the Teen Center building will be removed from the licensed program with plans to return the gymnasium to licensed space after August 23, 2024. We are waiting for further clarification and verification regarding the previously shared information that building, fire, and/or sanitation inspections would not be required when the gym is added back as licensed space for the licensed program at the end of the requested unlicensed period. I will pass along clarifying information as soon as I receive it. If DCDEE upper management determines, that building, fire, and/or sanitation inspections are required when you add the gym back to the licensed space, the Off-Premise Activity Permission Forms may continue to be used for the children enrolled in the licensed program to be able to continue to use the unlicensed gym. Please respond to this email to verify that you received this information and understand the approved terms for operating both a licensed and unlicensed program at the Hickory Foundation YMCA site. On May 28, 2024, I received an email response from Mr. Tallent that included an acknowledgement statement and a request for additional information regarding the use of the gymnasium after the summer. The response was as follows: We have received and acknowledge the requirements to operate licensed and unlicensed programming on the Hickory Foundation YMCA campus and will await further direction regarding usage of the gymnasium after the summer. COMPLIANCE PLAN: No compliance documentation is needed for violation item number 106 which was corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 4, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit , a visit summary was prepared, printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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. 601 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/21/2024 Number Present: 67 Completed Date: 8/21/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 09:02 AM Time Out: 12:10 PM Time In: 01:08 PM Time Out: 04:05 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Cassidy Dale, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on February 15, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Young Men's Christian Association Of Catawba Valley was reviewed and listed as current- active on the NC Secretary of State website on August 19, 2024. Your program’s compliance history was 87% as of August 19, 2024 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your last sanitation inspection was dated May 23, 2024 with a Superior classification and six demerits. I verified that you have completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicated that your facilities drinking water source was within the required limits. I verified that you have registered for the lead paint/asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024 after I requested you send me updated report by email. You and I visited each licensed indoor space and outdoor space today. I observed infant and one-year-old children engaged in floor play and routine care. I observed one-year-old children engaged in free play throughout the room. I observed two-year-old and three-year-old children transitioning from indoor play to outdoor play. I observed four-year-old children playing outside. I observed four-year and five-year-old children participating in a teacher-lead whole group language activity. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 34 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 41 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for four new staff members hired since the last annual compliance visit on February 15, 2024. I monitored health and safety requirements. You stated your facility uses the same employee and parent handbooks as O.L. Moretz Foundation YMCA Early Learning Center which is owned and operated by the same corporation. In February 2023, I reviewed your written operational, administrative, and personnel policies and your parent participation plan at a routine unannounced visit at O.L. Moretz Foundation YMCA Early Learning Center. On July 31, 2024 at an annual compliance visit at O.L. Moretz Foundation YMCA Early Learning Center, I reviewed the updated Parent Handbook which contained the operational policies and parent participation plan shared by your facility. You stated the administrative and personnel policies had not been updated since February 2023. I observed all the required components included in these written policies. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: 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 fire inspection report dated May 1, 2024 was received on May 31, 2024 by email per consultant request. 10A NCAC 09 .0304(a) 604 Lavatories were not kept clean, in good repair and kept free of storage. In Space 2, the trash can lid was visibly soiled. In Space 4, the handwashing sink was visibly soiled and the faucet fixture was corroded and beginning to rust. 15A NCAC 18A .2818(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 3, the wall by the handwashing sink was visibly soiled. In Space 4, the wall by the handwashing sink was visibly soiled, the paint was peeling in spots on the cinderblock wall, and the drywall was scarred and/or the paint was chipping in several spots. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. The finish on some furnishings including toy shelving and a child-size table and chair was worn off the wood and needed to be replaced or refinished. In Space 3, three toy shelves need to be replaced or refinished. In Space 4, 1 toy shelf needs to be replaced or refinished. In Space 5, one toy shelf, one child-size table and one child-size chair in the dramatic play area needs to be replaced or refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, the permission to administer forms for two non-prescription diaper ointments were missing required information. In Space 2, the permission to administer form for one non-prescription diaper ointment and one sunscreen were missing the amount to be applied. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer authorization for one non-presciption diaper ointment had expired and the medication had not been returned to the parent within 72 hours. In Space 3, the permission to administer authorization for four non-prescription diaper ointments had expired and the medications had not been returned to the parent within 72 hours. In Space 3, six non-presciption medications had expired and the medications had not been returned to the parent within 72 hours. .0803(12) 1041 Prior to employment a Criminal Background Check was not completed. One employee with a date of employment of 03/18/2024 who signed policy acknowlegdement statements on 03/08/2024 had a CBC qualification letter dated 03/15/2024. One employee with a date of employment of 07/29/2024 who signed policy acknowledgement statements on 07/15/2024 had a CBC qualification letter dated 07/18/2024. One employee with a date of employment of 08/05/2024 who signed policy acknowledgement statements on 07/17/2024 had a CBC qualification letter dated 07/19/2024. G.S. 110-90.2(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR Plan dated May 24, 2023 was not updated annually. .0607(e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. Prior to today’s visit, I received your fire inspection report dated May 1, 2024 on May 31, 2024 after I sent you an email reminder that your fire inspection was due. A violation was cited because the fire inspection report was not received within one week of its completion date. Because I received the violation prior to today’s visit, the violation was recorded as corrected during today’s visit. To maintain compliance with this child care requirement, I suggest you forward the email containing the fire inspection report when you receive it from the fire inspector. 2. Per sanitation rule 15A NCAC 18A .2818(a), lavatories including sinks should be kept clean, in good repair, and kept free of storage. To maintain compliance this sanitation rule, I suggest you have your staff deep clean the handwashing sinks and then wipe them clean daily. I also suggest you replace any faucets that are corroding and beginning to rust. 3. Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you touch up the peeling paint on the cinderblock walls and repair any wall scars and chipping paint on the drywall. 4. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 5. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. 6. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within 72 hours. To maintain compliance with this child care requirement, I suggest you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. 7. Per NC General Statute 110-90.2(b), each employee should have a Criminal Background Check (CBC) qualification letter on file prior to employment. As discussed today, employee’s may not complete any “onboarding procedures for new employees” prior to your receiving a CBC qualification letter. Completing “onboarding procedures for new employees” shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. New employees that come to you with a valid and current CBC qualification letter in hand may begin “onboarding procedures for new employees” as you wish. To maintain compliance with this child requirement, I suggest you speak with the human resource department for your organization and revise your “onboarding procedures for new employees” that are waiting to receive their CBC qualification letter. 8. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. An updated EPR Plan should be printed each and any time the EPR Plan is updated for any reason. To maintain compliance with child requirement, I suggest you contact the web portal for assistance in transferring this facility’s EPR Plan from the previous administrator to the current administrator. CONSULTATION: 1. Per sanitation rule 15A NCAC 18A.2832(a), the outdoor child care center premises, including the outdoor learning environment, should be kept drained to minimize standing water. As discussed today, your maintenance department should continue to explore solutions to the two areas on the Outdoor Play Space 2 where water has been pooling during heavy rain events. 2. Stackable cots should be stored in a way that prevents the top cot from being contaminated by children during play and classroom use. I suggested you place an extra unassigned cot on top of each stack of cots to prevent contamination in your classrooms where children two and under are enrolled and drape a vinyl tablecloth over each stack of cots in the classrooms where children three and older are enrolled. 3. When deciding the due date for the on-going training hours for your staff, you’ll have to look at each staff member and determine the due date for completion as follows: a) If the staff member had completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member will have until the next annual compliance date to complete the next annual requirement of on-going training hours. b) If the staff member had not completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member would be given until the annual compliance anniversary date to complete the on-going training requirement. c) If the staff member was newly hired since the last annual compliance visit, their on-going training hours would not be monitored the first year of employment with the assumption that they’ll complete the first-year training requirements for health & safety and other trainings which will account for the required number of hours. d) If the staff member was hired in 2024, their on-going training hours are required to be completed by their 2nd year employment anniversary and will be monitored at the next ACV. 4. As discussed today, when a violation is cited due to an issue in one specific classroom, staff file, or child file, best practice is to correct the violation in all the classrooms, all the staff files, and all the child files which also minimizes the risk of a repeat violation. Repeat violations could result in an administrative action due to a pattern of non-compliance. 5. Please post adult handwashing procedures at the handwashing sinks used by adults. 6. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 7. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 8. On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. 9. From 02/07/2024 to 05/23/2024, there was a series of email and phone call exchanges between Paxton Tallent, Executive Director of Services, at Hickory Foundation YMCA, and me regarding a request to operate unlicensed school-age child care for the summer months and throughout the school year. As a result of these conversations, expectations and requirements were shared with the Mr. Tallent and Nat Auten, CEO of Young Men’s Christian Association of Catawba Valley, the corporation that owns Hickory Foundation YMCA Child Development Center. On May 22, 2024, I requested a written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 24, 2024, I received the written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 28, 2024, I notified Mr. Tallent and Mr. Auten the response from DCDEE upper management regarding their written plan as follows: Your written plan for summer operation from May 28, 2024 through August 23, 2024 has been approved. Per your request, effective May 24, 2024, the age range on your license will be changed from 0 – 12 years to 0 -5 years. Please keep your current license posted in the Hickory Foundation YMCA Child Development Center until a new license/permit is processed and mailed to you. Per your request, the gymnasium and all other licensed spaces in the Teen Center building will be removed from the licensed program with plans to return the gymnasium to licensed space after August 23, 2024. We are waiting for further clarification and verification regarding the previously shared information that building, fire, and/or sanitation inspections would not be required when the gym is added back as licensed space for the licensed program at the end of the requested unlicensed period. I will pass along clarifying information as soon as I receive it. If DCDEE upper management determines, that building, fire, and/or sanitation inspections are required when you add the gym back to the licensed space, the Off-Premise Activity Permission Forms may continue to be used for the children enrolled in the licensed program to be able to continue to use the unlicensed gym. Please respond to this email to verify that you received this information and understand the approved terms for operating both a licensed and unlicensed program at the Hickory Foundation YMCA site. On May 28, 2024, I received an email response from Mr. Tallent that included an acknowledgement statement and a request for additional information regarding the use of the gymnasium after the summer. The response was as follows: We have received and acknowledge the requirements to operate licensed and unlicensed programming on the Hickory Foundation YMCA campus and will await further direction regarding usage of the gymnasium after the summer. COMPLIANCE PLAN: No compliance documentation is needed for violation item number 106 which was corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 4, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit , a visit summary was prepared, printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/21/2024 Number Present: 67 Completed Date: 8/21/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 09:02 AM Time Out: 12:10 PM Time In: 01:08 PM Time Out: 04:05 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Cassidy Dale, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on February 15, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Young Men's Christian Association Of Catawba Valley was reviewed and listed as current- active on the NC Secretary of State website on August 19, 2024. Your program’s compliance history was 87% as of August 19, 2024 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your last sanitation inspection was dated May 23, 2024 with a Superior classification and six demerits. I verified that you have completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicated that your facilities drinking water source was within the required limits. I verified that you have registered for the lead paint/asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024 after I requested you send me updated report by email. You and I visited each licensed indoor space and outdoor space today. I observed infant and one-year-old children engaged in floor play and routine care. I observed one-year-old children engaged in free play throughout the room. I observed two-year-old and three-year-old children transitioning from indoor play to outdoor play. I observed four-year-old children playing outside. I observed four-year and five-year-old children participating in a teacher-lead whole group language activity. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 34 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 41 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for four new staff members hired since the last annual compliance visit on February 15, 2024. I monitored health and safety requirements. You stated your facility uses the same employee and parent handbooks as O.L. Moretz Foundation YMCA Early Learning Center which is owned and operated by the same corporation. In February 2023, I reviewed your written operational, administrative, and personnel policies and your parent participation plan at a routine unannounced visit at O.L. Moretz Foundation YMCA Early Learning Center. On July 31, 2024 at an annual compliance visit at O.L. Moretz Foundation YMCA Early Learning Center, I reviewed the updated Parent Handbook which contained the operational policies and parent participation plan shared by your facility. You stated the administrative and personnel policies had not been updated since February 2023. I observed all the required components included in these written policies. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: 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 fire inspection report dated May 1, 2024 was received on May 31, 2024 by email per consultant request. 10A NCAC 09 .0304(a) 604 Lavatories were not kept clean, in good repair and kept free of storage. In Space 2, the trash can lid was visibly soiled. In Space 4, the handwashing sink was visibly soiled and the faucet fixture was corroded and beginning to rust. 15A NCAC 18A .2818(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 3, the wall by the handwashing sink was visibly soiled. In Space 4, the wall by the handwashing sink was visibly soiled, the paint was peeling in spots on the cinderblock wall, and the drywall was scarred and/or the paint was chipping in several spots. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. The finish on some furnishings including toy shelving and a child-size table and chair was worn off the wood and needed to be replaced or refinished. In Space 3, three toy shelves need to be replaced or refinished. In Space 4, 1 toy shelf needs to be replaced or refinished. In Space 5, one toy shelf, one child-size table and one child-size chair in the dramatic play area needs to be replaced or refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, the permission to administer forms for two non-prescription diaper ointments were missing required information. In Space 2, the permission to administer form for one non-prescription diaper ointment and one sunscreen were missing the amount to be applied. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer authorization for one non-presciption diaper ointment had expired and the medication had not been returned to the parent within 72 hours. In Space 3, the permission to administer authorization for four non-prescription diaper ointments had expired and the medications had not been returned to the parent within 72 hours. In Space 3, six non-presciption medications had expired and the medications had not been returned to the parent within 72 hours. .0803(12) 1041 Prior to employment a Criminal Background Check was not completed. One employee with a date of employment of 03/18/2024 who signed policy acknowlegdement statements on 03/08/2024 had a CBC qualification letter dated 03/15/2024. One employee with a date of employment of 07/29/2024 who signed policy acknowledgement statements on 07/15/2024 had a CBC qualification letter dated 07/18/2024. One employee with a date of employment of 08/05/2024 who signed policy acknowledgement statements on 07/17/2024 had a CBC qualification letter dated 07/19/2024. G.S. 110-90.2(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR Plan dated May 24, 2023 was not updated annually. .0607(e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. Prior to today’s visit, I received your fire inspection report dated May 1, 2024 on May 31, 2024 after I sent you an email reminder that your fire inspection was due. A violation was cited because the fire inspection report was not received within one week of its completion date. Because I received the violation prior to today’s visit, the violation was recorded as corrected during today’s visit. To maintain compliance with this child care requirement, I suggest you forward the email containing the fire inspection report when you receive it from the fire inspector. 2. Per sanitation rule 15A NCAC 18A .2818(a), lavatories including sinks should be kept clean, in good repair, and kept free of storage. To maintain compliance this sanitation rule, I suggest you have your staff deep clean the handwashing sinks and then wipe them clean daily. I also suggest you replace any faucets that are corroding and beginning to rust. 3. Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you touch up the peeling paint on the cinderblock walls and repair any wall scars and chipping paint on the drywall. 4. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 5. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. 6. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within 72 hours. To maintain compliance with this child care requirement, I suggest you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. 7. Per NC General Statute 110-90.2(b), each employee should have a Criminal Background Check (CBC) qualification letter on file prior to employment. As discussed today, employee’s may not complete any “onboarding procedures for new employees” prior to your receiving a CBC qualification letter. Completing “onboarding procedures for new employees” shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. New employees that come to you with a valid and current CBC qualification letter in hand may begin “onboarding procedures for new employees” as you wish. To maintain compliance with this child requirement, I suggest you speak with the human resource department for your organization and revise your “onboarding procedures for new employees” that are waiting to receive their CBC qualification letter. 8. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. An updated EPR Plan should be printed each and any time the EPR Plan is updated for any reason. To maintain compliance with child requirement, I suggest you contact the web portal for assistance in transferring this facility’s EPR Plan from the previous administrator to the current administrator. CONSULTATION: 1. Per sanitation rule 15A NCAC 18A.2832(a), the outdoor child care center premises, including the outdoor learning environment, should be kept drained to minimize standing water. As discussed today, your maintenance department should continue to explore solutions to the two areas on the Outdoor Play Space 2 where water has been pooling during heavy rain events. 2. Stackable cots should be stored in a way that prevents the top cot from being contaminated by children during play and classroom use. I suggested you place an extra unassigned cot on top of each stack of cots to prevent contamination in your classrooms where children two and under are enrolled and drape a vinyl tablecloth over each stack of cots in the classrooms where children three and older are enrolled. 3. When deciding the due date for the on-going training hours for your staff, you’ll have to look at each staff member and determine the due date for completion as follows: a) If the staff member had completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member will have until the next annual compliance date to complete the next annual requirement of on-going training hours. b) If the staff member had not completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member would be given until the annual compliance anniversary date to complete the on-going training requirement. c) If the staff member was newly hired since the last annual compliance visit, their on-going training hours would not be monitored the first year of employment with the assumption that they’ll complete the first-year training requirements for health & safety and other trainings which will account for the required number of hours. d) If the staff member was hired in 2024, their on-going training hours are required to be completed by their 2nd year employment anniversary and will be monitored at the next ACV. 4. As discussed today, when a violation is cited due to an issue in one specific classroom, staff file, or child file, best practice is to correct the violation in all the classrooms, all the staff files, and all the child files which also minimizes the risk of a repeat violation. Repeat violations could result in an administrative action due to a pattern of non-compliance. 5. Please post adult handwashing procedures at the handwashing sinks used by adults. 6. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 7. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 8. On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. 9. From 02/07/2024 to 05/23/2024, there was a series of email and phone call exchanges between Paxton Tallent, Executive Director of Services, at Hickory Foundation YMCA, and me regarding a request to operate unlicensed school-age child care for the summer months and throughout the school year. As a result of these conversations, expectations and requirements were shared with the Mr. Tallent and Nat Auten, CEO of Young Men’s Christian Association of Catawba Valley, the corporation that owns Hickory Foundation YMCA Child Development Center. On May 22, 2024, I requested a written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 24, 2024, I received the written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 28, 2024, I notified Mr. Tallent and Mr. Auten the response from DCDEE upper management regarding their written plan as follows: Your written plan for summer operation from May 28, 2024 through August 23, 2024 has been approved. Per your request, effective May 24, 2024, the age range on your license will be changed from 0 – 12 years to 0 -5 years. Please keep your current license posted in the Hickory Foundation YMCA Child Development Center until a new license/permit is processed and mailed to you. Per your request, the gymnasium and all other licensed spaces in the Teen Center building will be removed from the licensed program with plans to return the gymnasium to licensed space after August 23, 2024. We are waiting for further clarification and verification regarding the previously shared information that building, fire, and/or sanitation inspections would not be required when the gym is added back as licensed space for the licensed program at the end of the requested unlicensed period. I will pass along clarifying information as soon as I receive it. If DCDEE upper management determines, that building, fire, and/or sanitation inspections are required when you add the gym back to the licensed space, the Off-Premise Activity Permission Forms may continue to be used for the children enrolled in the licensed program to be able to continue to use the unlicensed gym. Please respond to this email to verify that you received this information and understand the approved terms for operating both a licensed and unlicensed program at the Hickory Foundation YMCA site. On May 28, 2024, I received an email response from Mr. Tallent that included an acknowledgement statement and a request for additional information regarding the use of the gymnasium after the summer. The response was as follows: We have received and acknowledge the requirements to operate licensed and unlicensed programming on the Hickory Foundation YMCA campus and will await further direction regarding usage of the gymnasium after the summer. COMPLIANCE PLAN: No compliance documentation is needed for violation item number 106 which was corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 4, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit , a visit summary was prepared, printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 8/21/2024 Number Present: 67 Completed Date: 8/21/2024 Age: From 0 To 5 Total Minutes: 365 Time In: 09:02 AM Time Out: 12:10 PM Time In: 01:08 PM Time Out: 04:05 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Cassidy Dale, Administrator, assisted me with today’s visit. I conducted your last annual compliance visit on February 15, 2024. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility. You stated there has been no change with the corporation, Young Men's Christian Association Of Catawba Valley, that owns your facility. I reviewed the facility’s permit with you today including the restrictions, capacity, and age range and observed these being maintained today. Young Men's Christian Association Of Catawba Valley was reviewed and listed as current- active on the NC Secretary of State website on August 19, 2024. Your program’s compliance history was 87% as of August 19, 2024 and was reviewed with you today. Your program currently operates with a four-star license, issued on May 28, 2024, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your last sanitation inspection was dated May 23, 2024 with a Superior classification and six demerits. I verified that you have completed the lead water testing required to be completed every three years. Today, I verified that those test results dated February 12, 2024 indicated that your facilities drinking water source was within the required limits. I verified that you have registered for the lead paint/asbestos testing. Your last fire inspection was dated May 1, 2024 and was received in my office on May 31, 2024 after I requested you send me updated report by email. You and I visited each licensed indoor space and outdoor space today. I observed infant and one-year-old children engaged in floor play and routine care. I observed one-year-old children engaged in free play throughout the room. I observed two-year-old and three-year-old children transitioning from indoor play to outdoor play. I observed four-year-old children playing outside. I observed four-year and five-year-old children participating in a teacher-lead whole group language activity. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 34 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 41 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, completion of Playground Safety training by at least one staff member, and completion of Emergency Preparedness and Response training by at least one staff member. I reviewed staff record files for four new staff members hired since the last annual compliance visit on February 15, 2024. I monitored health and safety requirements. You stated your facility uses the same employee and parent handbooks as O.L. Moretz Foundation YMCA Early Learning Center which is owned and operated by the same corporation. In February 2023, I reviewed your written operational, administrative, and personnel policies and your parent participation plan at a routine unannounced visit at O.L. Moretz Foundation YMCA Early Learning Center. On July 31, 2024 at an annual compliance visit at O.L. Moretz Foundation YMCA Early Learning Center, I reviewed the updated Parent Handbook which contained the operational policies and parent participation plan shared by your facility. You stated the administrative and personnel policies had not been updated since February 2023. I observed all the required components included in these written policies. I monitored supervision, staff-child ratios, group sizes, approved space use, space capacities, and permit restrictions. The following violations were cited during today’s visit: 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 fire inspection report dated May 1, 2024 was received on May 31, 2024 by email per consultant request. 10A NCAC 09 .0304(a) 604 Lavatories were not kept clean, in good repair and kept free of storage. In Space 2, the trash can lid was visibly soiled. In Space 4, the handwashing sink was visibly soiled and the faucet fixture was corroded and beginning to rust. 15A NCAC 18A .2818(a) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Space 3, the wall by the handwashing sink was visibly soiled. In Space 4, the wall by the handwashing sink was visibly soiled, the paint was peeling in spots on the cinderblock wall, and the drywall was scarred and/or the paint was chipping in several spots. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. The finish on some furnishings including toy shelving and a child-size table and chair was worn off the wood and needed to be replaced or refinished. In Space 3, three toy shelves need to be replaced or refinished. In Space 4, 1 toy shelf needs to be replaced or refinished. In Space 5, one toy shelf, one child-size table and one child-size chair in the dramatic play area needs to be replaced or refinished. G.S. 110-91(6); .0601(b) 847 Parent's medication authorization did not include required information. In Space 1, the permission to administer forms for two non-prescription diaper ointments were missing required information. In Space 2, the permission to administer form for one non-prescription diaper ointment and one sunscreen were missing the amount to be applied. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space 2, the permission to administer authorization for one non-presciption diaper ointment had expired and the medication had not been returned to the parent within 72 hours. In Space 3, the permission to administer authorization for four non-prescription diaper ointments had expired and the medications had not been returned to the parent within 72 hours. In Space 3, six non-presciption medications had expired and the medications had not been returned to the parent within 72 hours. .0803(12) 1041 Prior to employment a Criminal Background Check was not completed. One employee with a date of employment of 03/18/2024 who signed policy acknowlegdement statements on 03/08/2024 had a CBC qualification letter dated 03/15/2024. One employee with a date of employment of 07/29/2024 who signed policy acknowledgement statements on 07/15/2024 had a CBC qualification letter dated 07/18/2024. One employee with a date of employment of 08/05/2024 who signed policy acknowledgement statements on 07/17/2024 had a CBC qualification letter dated 07/19/2024. G.S. 110-90.2(b) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR Plan dated May 24, 2023 was not updated annually. .0607(e) TECHNICAL ASSISTANCE: 1. Per child care rule 10A NCAC 09 .0304(a), the original copy of the most recently approved fire inspection report should be sent to me by email within one week of completion. Prior to today’s visit, I received your fire inspection report dated May 1, 2024 on May 31, 2024 after I sent you an email reminder that your fire inspection was due. A violation was cited because the fire inspection report was not received within one week of its completion date. Because I received the violation prior to today’s visit, the violation was recorded as corrected during today’s visit. To maintain compliance with this child care requirement, I suggest you forward the email containing the fire inspection report when you receive it from the fire inspector. 2. Per sanitation rule 15A NCAC 18A .2818(a), lavatories including sinks should be kept clean, in good repair, and kept free of storage. To maintain compliance this sanitation rule, I suggest you have your staff deep clean the handwashing sinks and then wipe them clean daily. I also suggest you replace any faucets that are corroding and beginning to rust. 3. Per sanitation rule 15A NCAC 18A .2825(a), walls should be kept in good repair and clean. To maintain compliance with this sanitation rule, I suggest you touch up the peeling paint on the cinderblock walls and repair any wall scars and chipping paint on the drywall. 4. Per child care rule 10A NCAC 09. 601(b), all equipment and materials should be kept in good repair. To maintain compliance with this child care requirement, I suggest you have shelving and furniture replaced or refinished when you notice wear on the finish that results in the furniture no longer being easy to clean and impervious to moisture. Today, I advised you to keep your furniture and equipment in good repair at all times and make repairs or replacements before violations are cited. 5. Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. 6. Per child care rule 10A NCAC 09 .0803(12), when a medication, prescription, or permission to administer form has expired, the medication should be returned to the parent within 72 hours. To maintain compliance with this child care requirement, I suggest you review medications and permission to administer forms routinely to ensure ongoing compliance. When an expired medication is brought to the center from home, the expired medication should not be received by the center. 7. Per NC General Statute 110-90.2(b), each employee should have a Criminal Background Check (CBC) qualification letter on file prior to employment. As discussed today, employee’s may not complete any “onboarding procedures for new employees” prior to your receiving a CBC qualification letter. Completing “onboarding procedures for new employees” shows an intent to hire and an employee cannot be hired prior to verifying the employee’s qualification as a child care provider. New employees that come to you with a valid and current CBC qualification letter in hand may begin “onboarding procedures for new employees” as you wish. To maintain compliance with this child requirement, I suggest you speak with the human resource department for your organization and revise your “onboarding procedures for new employees” that are waiting to receive their CBC qualification letter. 8. Per child care rule 10A NCAC 09 .0607(e), the Emergency Preparedness Response (EPR) Plan should be reviewed and updated by the person on staff who took the EPR Training course at least annually and when any changes to the plan are necessary. An updated EPR Plan should be printed each and any time the EPR Plan is updated for any reason. To maintain compliance with child requirement, I suggest you contact the web portal for assistance in transferring this facility’s EPR Plan from the previous administrator to the current administrator. CONSULTATION: 1. Per sanitation rule 15A NCAC 18A.2832(a), the outdoor child care center premises, including the outdoor learning environment, should be kept drained to minimize standing water. As discussed today, your maintenance department should continue to explore solutions to the two areas on the Outdoor Play Space 2 where water has been pooling during heavy rain events. 2. Stackable cots should be stored in a way that prevents the top cot from being contaminated by children during play and classroom use. I suggested you place an extra unassigned cot on top of each stack of cots to prevent contamination in your classrooms where children two and under are enrolled and drape a vinyl tablecloth over each stack of cots in the classrooms where children three and older are enrolled. 3. When deciding the due date for the on-going training hours for your staff, you’ll have to look at each staff member and determine the due date for completion as follows: a) If the staff member had completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member will have until the next annual compliance date to complete the next annual requirement of on-going training hours. b) If the staff member had not completed their on-going training hour requirement by the annual compliance anniversary date, then that staff member would be given until the annual compliance anniversary date to complete the on-going training requirement. c) If the staff member was newly hired since the last annual compliance visit, their on-going training hours would not be monitored the first year of employment with the assumption that they’ll complete the first-year training requirements for health & safety and other trainings which will account for the required number of hours. d) If the staff member was hired in 2024, their on-going training hours are required to be completed by their 2nd year employment anniversary and will be monitored at the next ACV. 4. As discussed today, when a violation is cited due to an issue in one specific classroom, staff file, or child file, best practice is to correct the violation in all the classrooms, all the staff files, and all the child files which also minimizes the risk of a repeat violation. Repeat violations could result in an administrative action due to a pattern of non-compliance. 5. Please post adult handwashing procedures at the handwashing sinks used by adults. 6. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 7. Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 8. On Friday, July 12, 2024, DCDEE sent a “Raise North Carolina” email blast announcing the signing of Senate Bill 425. The email contained a section entitled, “Quality Rating Improvement System (QRIS) Modernization” which provided updated information regarding the Rated License Reassessment process and approved extended stabilization grant funding. What does all this mean for child care in general? 1. The new QRIS Modifications and additional pathways will be added to law which included moving to the use of the updated Environmental Rating Scale (ERS-3 versions) for ECCERS. ITERS and FCCERS, effective February 1, 2025. DCDEE and the NC Child Care Commission have already begun the rulemaking process to add the rule language to child care requirements. This process with take several months. 2. Hold Harmless provisions have been extended. Star rated license reassessments are postponed until the QRIS rulemaking process has been completed. Providers in any Cohort may voluntarily request a star rated license reassessment if they wish. Star rated license assessments are still required for new child care programs. 3. A pathway for child care programs currently accredited through the approved accrediting bodies may now move to a 3- or 5-star license if they are not already at this star level. Providers will need to submit a request to their licensing consultant and provide a copy of their accreditation award/certificate for processing: Accreditation Licensure Request Form. What does all this mean for facilities in Cohorts 1 & 2? A facility may voluntarily request to complete the star rated license reassessment at any time but will not be required to complete the star rated license reassessment process this year. What does this mean for the Environmental Rating Scales? Please be reminded that if a facility voluntarily chooses to complete the star rated license reassessment AND chooses to complete one or more Environmental Rating Scale (ERS) assessments, the ERS-revised editions will continue to be used until January 31, 2025. Any ERS assessment completed on February 1, 2025 and after will be assessed using the ERS-3 versions. If you wish to VOLUNTARILY move forward with a rated license reassessment, please reach out to me as soon as possible so plans can be made on both our calendars to ensure ease and success with completing the star rated license reassessment process in a timely manner that benefits us both. 9. From 02/07/2024 to 05/23/2024, there was a series of email and phone call exchanges between Paxton Tallent, Executive Director of Services, at Hickory Foundation YMCA, and me regarding a request to operate unlicensed school-age child care for the summer months and throughout the school year. As a result of these conversations, expectations and requirements were shared with the Mr. Tallent and Nat Auten, CEO of Young Men’s Christian Association of Catawba Valley, the corporation that owns Hickory Foundation YMCA Child Development Center. On May 22, 2024, I requested a written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 24, 2024, I received the written plan to operate full-day unlicensed summer care for school-aged children and half-day unlicensed summer care for preschool children and half-day unlicensed care for school-aged children during the school year and the request to remove the licensed spaces in the Teen Center building from the licensed primary spaces for the facility. On May 28, 2024, I notified Mr. Tallent and Mr. Auten the response from DCDEE upper management regarding their written plan as follows: Your written plan for summer operation from May 28, 2024 through August 23, 2024 has been approved. Per your request, effective May 24, 2024, the age range on your license will be changed from 0 – 12 years to 0 -5 years. Please keep your current license posted in the Hickory Foundation YMCA Child Development Center until a new license/permit is processed and mailed to you. Per your request, the gymnasium and all other licensed spaces in the Teen Center building will be removed from the licensed program with plans to return the gymnasium to licensed space after August 23, 2024. We are waiting for further clarification and verification regarding the previously shared information that building, fire, and/or sanitation inspections would not be required when the gym is added back as licensed space for the licensed program at the end of the requested unlicensed period. I will pass along clarifying information as soon as I receive it. If DCDEE upper management determines, that building, fire, and/or sanitation inspections are required when you add the gym back to the licensed space, the Off-Premise Activity Permission Forms may continue to be used for the children enrolled in the licensed program to be able to continue to use the unlicensed gym. Please respond to this email to verify that you received this information and understand the approved terms for operating both a licensed and unlicensed program at the Hickory Foundation YMCA site. On May 28, 2024, I received an email response from Mr. Tallent that included an acknowledgement statement and a request for additional information regarding the use of the gymnasium after the summer. The response was as follows: We have received and acknowledge the requirements to operate licensed and unlicensed programming on the Hickory Foundation YMCA campus and will await further direction regarding usage of the gymnasium after the summer. COMPLIANCE PLAN: No compliance documentation is needed for violation item number 106 which was corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than September 4, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit , a visit summary was prepared, printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0703 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0710 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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 .0714 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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. 601 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 2/21/2024 Number Present: 62 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 445 Time In: 09:05 AM Time Out: 12:50 PM Time In: 01:50 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Cassidy Dale, Administrator, and Susan Rowe, Assistant Director, assisted me with today’s visit. I conducted your last annual compliance visit on March 16, 2023. Your program currently operates with a four-star license, issued on August 17, 2020, earning four points in staff education, five points in program standards, and one quality point for meeting Programmatic Option: Has met two of the following 3 standards: enhanced policies approved and staff benefits package. Your program’s compliance history was 87% as of February 12, 2024 and was reviewed with you today. Your last sanitation inspection was dated December 4, 2023 with a Superior classification and four demerits. Your last fire inspection was dated May 10, 2023 and was received in my office on May 11, 2023. You and I visited each licensed indoor space in and each licensed outdoor space in both buildings with you today. I observed spaces 8, 9, 10, 11, and 12 in the Teen Center building were not being used for child care today. I observed Outdoor Space 3 (School Age) was not being used for child care today. I observed infant and one-year-old children engaged in floor play. I observed one-year-old children transitioning to outdoor play. I observed one- and two-year-old children transitioning from outdoor play to indoor play, participating in a teacher-directed craft project with fingerprints and eating lunch. I observed two- through five-year-old children playing outside. You stated your facility uses Explorations with Young Children as the approved curriculum for a 4-Star facility serving children who are four and five years of age. You stated your facility voluntarily uses Explorations with Young Children as the approved curriculum for three-year-old children. You stated your facility voluntarily uses Creative Curriculum as the approved curriculum for infant through two-year-old children. I observed a current menu documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. I observed lunch prepared in the kitchen and served in the classrooms. I observed cold food and milk stored in a commercial refrigerator in the kitchen at a temperature of 33 degrees Fahrenheit. I observed infant bottles stored in a refrigerator in Space 1 (Infant Room) at a temperature of 32 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” for today’s visit. I observed and cited the following violations during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In Space 3, the posted activity plan was dated 02/12/2024 - 02/16/2024. The teacher created a new activity plan dated 02/19/2024 - 02/23/2024 and posted it in the classroom during the visit. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On Outdoor Space 2, the fence by the raised garden beds had a hole underneath the fence large enough for an animal to enter the outdoor play area or a small child to crawl or slip under the fence. 10A NCAC 09 .0601(a) 847 Parent's medication authorization did not include required information. In Space 1, one form for permission to administrer an over-the-counter diaper cream was missing the information for how to apply the medication. In Space 3, one medication permission to administer form authorizing administration of a presciption medication for a chronic illness was missing the valid dates the medication could be administered. 10A NCAC 09 .0803(4)(6-9) TECHNICAL ASSISTANCE: 1 Per child care rule 10A NCAC 09 .0508(a), the activity plans should be current. To maintain compliance with this child care requirement, I suggest you monitor classrooms weekly as a check and balance system to ensure required postings and record-keeping tasks are being completed as expected. 2 Per child care rule 10A NCAC 09. 601(a), child care facilities are expected to provide a safe indoor and outdoor environment for children. To maintain, compliance with this child care requirement, I suggest you conduct daily safety checks of the indoor and outdoor environments prior to the children using the licensed classroom and outdoor spaces. 3 Per child care rule 10A NCAC 09 .0803(7), on the medication permission to administer form, the parent should include the name of the medication, the valid dates for the medication to be administered, the amount of medication to be administered, and the manner in which the medication is to be administered. To maintain compliance with this child care requirement, I suggest you and your staff review the medication permission slip when it is received from the parent to be sure all the required information has been provided by the parent. If any information is missing, I advise you and your staff to have the parents provide the information immediately before leaving the medication with you. CONSULTATION: 1 Children’s books and literacy supplies must be made available and accessible daily to children three years of age and older with enough supplies for three children to play with the same or different materials or toys at the same or different time. I suggest you add a third material to the book area such as a flannel board and flannel pieces, alphabet puzzles, alphabet flash cards, or magnetic letters in the classroom where two- and three-year-old children are combined. 2 Staff from the “Stretch and Grow” program who have a valid and current Criminal Background Check (CBC) letter on file at the facility may supervise a group of children without facility staff present as long as the “Stretch and Grow” staff have enough staff members present to maintain staff to child ratios. Staff to child ratios should be maintained at all times. Staff and uncompensated providers supervising children alone should have a current and valid CBC qualification letter on file at all times. 3 The electronic child enrollment application recently placed in use by the facility was shared with me today. You asked me to review the electronic child enrollment application and give my approval or consultation as needed. After reviewing the electronic child enrollment application, I suggest you add a parent signature and date line to the application page. I also suggest that you print the Disciple and Behavior Management Policy page and add it to the child’s file even though it is included on the attestation page. I suggest you add the child’s name and the child’s date of enrollment to the Discipline and Behavior Management Policy page once printed since that required information is not included on the policy when it is printed. 4 As reviewed with you today, per child care rule 10A NCAC 09 .0710(b), a lead teacher or a teacher should be 18 years of age, have a high school diploma or its equivalent, and have one of the following: (1) One year of child care experience working in a child care center or two years of verifiable experience as a licensed family child care home operator; or (2) Completion of a two-year high school program of Early Childhood Education in Family and Consumer Sciences Education; or (3) Twenty hours of training in child development, which shall include the North Carolina Early Childhood Credential coursework, within the first six months of employment in addition to the number of on-going training hours required in Rule .1103 of this Chapter. 5 As reviewed with you today, per child care rule 10A NCAC 09 .0714(c), one person who meets the requirements for a lead teacher should be responsible for each group of children. This requirement may be met by having one or more persons who meet the requirements for a lead teacher responsible for the same group of children. Each lead teacher shall be responsible for only one group of children at a time. Each group of children shall have a lead teacher in attendance for at least two-thirds of the total daily hours of operation, based on a normal working schedule, and may include times when the lead teacher may not be in attendance due to circumstances such as illness or vacation. 6 As reviewed with you today, per child care rule 10A NCAC 09 .0714(d), no teacher’s aide should have responsibility for a group of children. 7As reviewed with you today, per child care rule 10A NCAC 09 .0703(a), child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section should meet the requirements of G.S. 110-91(8). No one under 18 years of age should have responsibility for or be left in charge of a group of children. 8 Per child care rule 10A NCAC 09 .0703(b), on or before the first day of work, the operator should verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth should be maintained in the individual's personnel file in the center. Age should be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. 9 As reviewed with you today, per child care rule 10A NCAC 09 .0703(c), within six months of an individual assuming lead teacher or child care administrator duties, each center should maintain the following information in the individual's staff record: (1) a copy of the credential certificate; (2) a copy of notification from the Division that the individual meets the equivalency or that the individual does not meet the equivalency and must enroll in coursework; (3) a dated copy of the request submitted by the individual to the Division for the assessment of equivalency status; or (4) documentation of enrollment in credential coursework. 10 As reviewed with you today, per child care rule 10A NCAC 09 .0703(d), if the individual does not yet meet the staff qualifications required by G.S. 110-91(8) when assuming lead teacher or administrative duties, the individual should submit to the Division documentation of completion of the coursework or credential to be considered for equivalency within six months of assuming the duties. 11 Per child care rule 10A NCAC 09 .0803 (7), a parent may give standing authorization for up to 12 months to apply over the counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization should be in writing and should contain: (a) the child's name; (b) the name of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) when and the amount to administer the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) how to apply the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. 12 Per child care rule 10A NCAC 09 .0803 (6), a parent may give standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and should include: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. 13 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 14 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. 15 The Change of Information form for CBC is listed in law. When a new staff member starts working at a facility and gives the administrator a CBC qualification letter that was previously completed while working at another facility, but is still current, the administrator must send a Change of Information form for that new staff member to the CBC unit. The Change of Information form can be found on DCDEE’s website under Provider Documents and Forms. 16 The Staff Health Assessment/Medical Report form should include the date of the assessment as the date the health exam was completed as well as the health care professional’s signature and date of signature. To maintain compliance with this child care requirement, I suggest you highlight the “date of the assessment” on the document so remind health care professionals that information is required in addition to their signature and date of signature. 17 The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways • ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality • If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment • Assessment scores can be saved to use during the reassessment year • Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 1) Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2) Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than March 6, 2024. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit due to time restraints, a handwritten visit summary was prepared, printed, reviewed, and a copy was left with you today. Within two business days, a computer-generated visit summary packet will be prepared, printed, and mailed to the facility mailing address. Please call me to review the visit summary packet when you receive it in the mail. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/21/2023 Number Present: 49 Completed Date: 9/21/2023 Age: From 0 To 4 Total Minutes: 370 Time In: 09:05 AM Time Out: 12:30 PM Time In: 01:30 PM Time Out: 04:15 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Nancy Mitchell, Administrator, assisted me with today’s visit. Your program currently operates with a four-star license, issued on August 17, 2020, earning 4 points in staff education, 5 points in program standards, and 1 quality point for having enhanced policies approved and staff benefit package. Your center's compliance history was 86% as of September 20, 2023 and was reviewed with you today. Your facility, owned by Young Men's Christian Association of Catawba Valley, was reviewed on the NC Secretary of State website on September 20, 2023 and was viewed as current- active. Your most recent fire inspection was dated May 3, 2023 and received in my office on May 5, 2023. Your most recent sanitation inspection was dated May 10, 2023 with a Superior classification and 4 demerits. You and I completed a walk-through of the facility today. I monitored all indoor and outdoor areas. I observed children participating in group time, free play in activity areas and outdoors, transitions, and personal care. I observed no school age children in attendance or enrolled today as you stated the school age children had returned to school for the 2023 – 2024 school year and would not be attending during breaks in the school calendar due to staffing and construction on the YMCA property. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratios maintained during today’s visit. I observed adequate approved enhanced space used during today’s visit. I observed permit restrictions including “1st & 2nd shift”, “Spaces 8, 9, 10, 11, & 12 for school-age care only”, “meets enhanced ratios” and “meets enhanced space” maintained during today’s visit. I reviewed staff record files for three new staff members. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, and completion of Basic School Age Care training as required for the staff members who worked with school-age children over the summer months. I monitored health and safety training initial and renewal requirements today. The following violations were cited during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. In Space 4, the rubber baseboard in the classroom bathroom was detached from the wall. On Outdoor Space 1, the interior fence was pulled away from the center support pole. On Outdoor Space 2, the exterior fence in the corner had separating and broken links in the fence. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 5 and Space 6, sunscreen was stored above five feet. The teacher and the director moved the sunscreen to a locked cabinet. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In Space 3, one emergency prescription medication was missing a medication permission to administer form and log. 10A NCAC 09 .0803(4)(6-9) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In Space 4, a set of foam blocks was available to two-year-old children. The assistant director removed the set of foam blocks from the classroom. .0604(q) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 07/06/2022 did not complete the health and safety training within the first year of employment. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Three staff members with a dates of employment of 10/12/2016, 06/27/2017, and 05/13/2019 did not complete health and safety training topics within the five year period. The three staff members had completed all health and safety trainings at the time of this visit. .1103(b) Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than October 5, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per sanitation rule 15A NCAC 18A.2825(a), floors and baseboards should be kept in good repair and clean. 2) Per child care rule 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. 3) Per child care rule 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five (5) years. 4) As discussed today, the due date of the H&S training five (5) year renewal is calculated five (5) years from the date on each H&S training certificate. 5) The medication permission to administer form for prescription or over the counter medications to be given for a chronic illness should be updated every six months. 6) When children move to a new classroom, the best practice would be to have the parent sign the group permission form giving the new teacher permission to administer the sunscreen provided by the center. You could also provide the new teacher with a copy of the permission to administer form from the old classroom. 7) Your two-year-old/three-year-old combination classroom should be prepared for the ITERS and the ECERS assessments since determining the assessment scale used will be based on a percentage of two-year-olds and three-year-olds. 8) Best practice is to promote children to the next age group as soon as a spot and staffing allows. 9) The fence should be kept in good repair. 10) Foam products including foam blocks should not be used in classrooms where children younger than three-years attend. 11) Sunscreen should be stored in a locked cabinet, drawer, or closet. The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/21/2023 Number Present: 49 Completed Date: 9/21/2023 Age: From 0 To 4 Total Minutes: 370 Time In: 09:05 AM Time Out: 12:30 PM Time In: 01:30 PM Time Out: 04:15 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Nancy Mitchell, Administrator, assisted me with today’s visit. Your program currently operates with a four-star license, issued on August 17, 2020, earning 4 points in staff education, 5 points in program standards, and 1 quality point for having enhanced policies approved and staff benefit package. Your center's compliance history was 86% as of September 20, 2023 and was reviewed with you today. Your facility, owned by Young Men's Christian Association of Catawba Valley, was reviewed on the NC Secretary of State website on September 20, 2023 and was viewed as current- active. Your most recent fire inspection was dated May 3, 2023 and received in my office on May 5, 2023. Your most recent sanitation inspection was dated May 10, 2023 with a Superior classification and 4 demerits. You and I completed a walk-through of the facility today. I monitored all indoor and outdoor areas. I observed children participating in group time, free play in activity areas and outdoors, transitions, and personal care. I observed no school age children in attendance or enrolled today as you stated the school age children had returned to school for the 2023 – 2024 school year and would not be attending during breaks in the school calendar due to staffing and construction on the YMCA property. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratios maintained during today’s visit. I observed adequate approved enhanced space used during today’s visit. I observed permit restrictions including “1st & 2nd shift”, “Spaces 8, 9, 10, 11, & 12 for school-age care only”, “meets enhanced ratios” and “meets enhanced space” maintained during today’s visit. I reviewed staff record files for three new staff members. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, and completion of Basic School Age Care training as required for the staff members who worked with school-age children over the summer months. I monitored health and safety training initial and renewal requirements today. The following violations were cited during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. In Space 4, the rubber baseboard in the classroom bathroom was detached from the wall. On Outdoor Space 1, the interior fence was pulled away from the center support pole. On Outdoor Space 2, the exterior fence in the corner had separating and broken links in the fence. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 5 and Space 6, sunscreen was stored above five feet. The teacher and the director moved the sunscreen to a locked cabinet. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In Space 3, one emergency prescription medication was missing a medication permission to administer form and log. 10A NCAC 09 .0803(4)(6-9) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In Space 4, a set of foam blocks was available to two-year-old children. The assistant director removed the set of foam blocks from the classroom. .0604(q) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 07/06/2022 did not complete the health and safety training within the first year of employment. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Three staff members with a dates of employment of 10/12/2016, 06/27/2017, and 05/13/2019 did not complete health and safety training topics within the five year period. The three staff members had completed all health and safety trainings at the time of this visit. .1103(b) Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than October 5, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per sanitation rule 15A NCAC 18A.2825(a), floors and baseboards should be kept in good repair and clean. 2) Per child care rule 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. 3) Per child care rule 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five (5) years. 4) As discussed today, the due date of the H&S training five (5) year renewal is calculated five (5) years from the date on each H&S training certificate. 5) The medication permission to administer form for prescription or over the counter medications to be given for a chronic illness should be updated every six months. 6) When children move to a new classroom, the best practice would be to have the parent sign the group permission form giving the new teacher permission to administer the sunscreen provided by the center. You could also provide the new teacher with a copy of the permission to administer form from the old classroom. 7) Your two-year-old/three-year-old combination classroom should be prepared for the ITERS and the ECERS assessments since determining the assessment scale used will be based on a percentage of two-year-olds and three-year-olds. 8) Best practice is to promote children to the next age group as soon as a spot and staffing allows. 9) The fence should be kept in good repair. 10) Foam products including foam blocks should not be used in classrooms where children younger than three-years attend. 11) Sunscreen should be stored in a locked cabinet, drawer, or closet. The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/21/2023 Number Present: 49 Completed Date: 9/21/2023 Age: From 0 To 4 Total Minutes: 370 Time In: 09:05 AM Time Out: 12:30 PM Time In: 01:30 PM Time Out: 04:15 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Nancy Mitchell, Administrator, assisted me with today’s visit. Your program currently operates with a four-star license, issued on August 17, 2020, earning 4 points in staff education, 5 points in program standards, and 1 quality point for having enhanced policies approved and staff benefit package. Your center's compliance history was 86% as of September 20, 2023 and was reviewed with you today. Your facility, owned by Young Men's Christian Association of Catawba Valley, was reviewed on the NC Secretary of State website on September 20, 2023 and was viewed as current- active. Your most recent fire inspection was dated May 3, 2023 and received in my office on May 5, 2023. Your most recent sanitation inspection was dated May 10, 2023 with a Superior classification and 4 demerits. You and I completed a walk-through of the facility today. I monitored all indoor and outdoor areas. I observed children participating in group time, free play in activity areas and outdoors, transitions, and personal care. I observed no school age children in attendance or enrolled today as you stated the school age children had returned to school for the 2023 – 2024 school year and would not be attending during breaks in the school calendar due to staffing and construction on the YMCA property. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratios maintained during today’s visit. I observed adequate approved enhanced space used during today’s visit. I observed permit restrictions including “1st & 2nd shift”, “Spaces 8, 9, 10, 11, & 12 for school-age care only”, “meets enhanced ratios” and “meets enhanced space” maintained during today’s visit. I reviewed staff record files for three new staff members. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, and completion of Basic School Age Care training as required for the staff members who worked with school-age children over the summer months. I monitored health and safety training initial and renewal requirements today. The following violations were cited during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. In Space 4, the rubber baseboard in the classroom bathroom was detached from the wall. On Outdoor Space 1, the interior fence was pulled away from the center support pole. On Outdoor Space 2, the exterior fence in the corner had separating and broken links in the fence. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 5 and Space 6, sunscreen was stored above five feet. The teacher and the director moved the sunscreen to a locked cabinet. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In Space 3, one emergency prescription medication was missing a medication permission to administer form and log. 10A NCAC 09 .0803(4)(6-9) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In Space 4, a set of foam blocks was available to two-year-old children. The assistant director removed the set of foam blocks from the classroom. .0604(q) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 07/06/2022 did not complete the health and safety training within the first year of employment. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Three staff members with a dates of employment of 10/12/2016, 06/27/2017, and 05/13/2019 did not complete health and safety training topics within the five year period. The three staff members had completed all health and safety trainings at the time of this visit. .1103(b) Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than October 5, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per sanitation rule 15A NCAC 18A.2825(a), floors and baseboards should be kept in good repair and clean. 2) Per child care rule 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. 3) Per child care rule 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five (5) years. 4) As discussed today, the due date of the H&S training five (5) year renewal is calculated five (5) years from the date on each H&S training certificate. 5) The medication permission to administer form for prescription or over the counter medications to be given for a chronic illness should be updated every six months. 6) When children move to a new classroom, the best practice would be to have the parent sign the group permission form giving the new teacher permission to administer the sunscreen provided by the center. You could also provide the new teacher with a copy of the permission to administer form from the old classroom. 7) Your two-year-old/three-year-old combination classroom should be prepared for the ITERS and the ECERS assessments since determining the assessment scale used will be based on a percentage of two-year-olds and three-year-olds. 8) Best practice is to promote children to the next age group as soon as a spot and staffing allows. 9) The fence should be kept in good repair. 10) Foam products including foam blocks should not be used in classrooms where children younger than three-years attend. 11) Sunscreen should be stored in a locked cabinet, drawer, or closet. The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: Visit Date: 9/21/2023 Number Present: 49 Completed Date: 9/21/2023 Age: From 0 To 4 Total Minutes: 370 Time In: 09:05 AM Time Out: 12:30 PM Time In: 01:30 PM Time Out: 04:15 PM List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Nancy Mitchell, Administrator, assisted me with today’s visit. Your program currently operates with a four-star license, issued on August 17, 2020, earning 4 points in staff education, 5 points in program standards, and 1 quality point for having enhanced policies approved and staff benefit package. Your center's compliance history was 86% as of September 20, 2023 and was reviewed with you today. Your facility, owned by Young Men's Christian Association of Catawba Valley, was reviewed on the NC Secretary of State website on September 20, 2023 and was viewed as current- active. Your most recent fire inspection was dated May 3, 2023 and received in my office on May 5, 2023. Your most recent sanitation inspection was dated May 10, 2023 with a Superior classification and 4 demerits. You and I completed a walk-through of the facility today. I monitored all indoor and outdoor areas. I observed children participating in group time, free play in activity areas and outdoors, transitions, and personal care. I observed no school age children in attendance or enrolled today as you stated the school age children had returned to school for the 2023 – 2024 school year and would not be attending during breaks in the school calendar due to staffing and construction on the YMCA property. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratios maintained during today’s visit. I observed adequate approved enhanced space used during today’s visit. I observed permit restrictions including “1st & 2nd shift”, “Spaces 8, 9, 10, 11, & 12 for school-age care only”, “meets enhanced ratios” and “meets enhanced space” maintained during today’s visit. I reviewed staff record files for three new staff members. I reviewed staff record files for fifteen returning staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training, completion of the Recognizing and Responding to Suspicions of Child Maltreatment training, and completion of Basic School Age Care training as required for the staff members who worked with school-age children over the summer months. I monitored health and safety training initial and renewal requirements today. The following violations were cited during today’s visit: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. In Space 4, the rubber baseboard in the classroom bathroom was detached from the wall. On Outdoor Space 1, the interior fence was pulled away from the center support pole. On Outdoor Space 2, the exterior fence in the corner had separating and broken links in the fence. G.S. 110-91(6); .0601(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In Space 5 and Space 6, sunscreen was stored above five feet. The teacher and the director moved the sunscreen to a locked cabinet. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. In Space 3, one emergency prescription medication was missing a medication permission to administer form and log. 10A NCAC 09 .0803(4)(6-9) 861 Prohibited styrofoam and foam rubber products were accessible to children under 3 years of age and/or approved foam products were used without proper supervision. In Space 4, a set of foam blocks was available to two-year-old children. The assistant director removed the set of foam blocks from the classroom. .0604(q) 1898 Staff did not complete the health and safety training within one year of employment. One staff member with a date of employment of 07/06/2022 did not complete the health and safety training within the first year of employment. .1102(a) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Three staff members with a dates of employment of 10/12/2016, 06/27/2017, and 05/13/2019 did not complete health and safety training topics within the five year period. The three staff members had completed all health and safety trainings at the time of this visit. .1103(b) Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than October 5, 2023. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Per sanitation rule 15A NCAC 18A.2825(a), floors and baseboards should be kept in good repair and clean. 2) Per child care rule 10A NCAC 09 .1102(a), new employee’s must complete the Health & Safety (H&S) Training requirement within the first year of employment. 3) Per child care rule 10A NCAC 09 .1103(b), returning employees must revisit each H&S Training topic every five (5) years. 4) As discussed today, the due date of the H&S training five (5) year renewal is calculated five (5) years from the date on each H&S training certificate. 5) The medication permission to administer form for prescription or over the counter medications to be given for a chronic illness should be updated every six months. 6) When children move to a new classroom, the best practice would be to have the parent sign the group permission form giving the new teacher permission to administer the sunscreen provided by the center. You could also provide the new teacher with a copy of the permission to administer form from the old classroom. 7) Your two-year-old/three-year-old combination classroom should be prepared for the ITERS and the ECERS assessments since determining the assessment scale used will be based on a percentage of two-year-olds and three-year-olds. 8) Best practice is to promote children to the next age group as soon as a spot and staffing allows. 9) The fence should be kept in good repair. 10) Foam products including foam blocks should not be used in classrooms where children younger than three-years attend. 11) Sunscreen should be stored in a locked cabinet, drawer, or closet. The hold harmless legislation was extended and signed into law on June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in Cohort 1. Throughout the next few months, I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, and/or SACERS-U] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 If you have questions, please contact me. I look forward to helping you through this rated license reassessment process At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or our lead consultant and interim supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: HICKORY FOUNDATION YMCA CHILD DEVELOPMENT CENTER Facility ID: 18000146 Consultant: KIMBERLY CRANE Operation Type: Center Case Number: 0723-103L Visit Date: 7/26/2023 Number Present: 98 Completed Date: 7/26/2023 Age: From 0 To 12 Total Minutes: 335 Time In: 10:45 AM Time Out: 12:45 PM Time In: 02:05 PM Time Out: 05:40 PM List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to gather information regarding alleged violations of child care requirements. Susan Rowe, Assistant Administrator, assisted me with today’s visit. According to the report, there is a concern of inadequate supervision in the classroom for 2-year-old children. There is a concern that children were not attended to in a nurturing and appropriate manner or in keeping with the children’s developmental needs. Today, you reported 120 children ranging in age from zero to twelve years of age were enrolled in your facility this week. You reported 98 children ranging in age from zero to twelve years of age were present today. You reported children enroll weekly for school-age summer care. Due to the nature of the report, a walk-through of the entire facility was not necessary today. I conducted a walk-through of your facility visiting three out of six classrooms located on the child development center hallway in the main building of the YMCA. I observed children playing in activity areas, eating lunch, preparing for nap, napping, eating snack, playing outside, and departing. Today, I investigated the concern of inadequate supervision in the classroom for 2-year-old children. I interviewed 5 staff members today. Staff recalled incidents of biting. Staff recalled parent concerns being addressed as soon as possible. Staff stated most of the biting incidents occurred after the child was provoked. Staff stated an incident report was completed and given to each parent of the child that was bitten. Staff stated a note was left on the cubby of the child who bit as well as the child who was bitten. Today, I observed a “Biting Log” which maintained in the classrooms for two-year-old children. I observed adequate supervision practices today. I observed staff positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance as needed. I observed staff interacting with the children while moving about the indoor or outdoor area. I observed staff know where each child was located and aware of the children's activities at all times. I observed staff provide supervision appropriate to the individual age, needs, and capabilities of each child. I observed staff able to see and hear children aged birth to five years old while the children ate. Based on my observations, interviews with staff, and review of the “Biting Log”, the allegation of inadequate supervision was unsubstantiated. I investigated the concern that children were not attended to in a nurturing and appropriate manner or in keeping with the children’s developmental needs. I interviewed 7 staff members today. Staff recalled times when a two-year-old child was spoken to in a loud and harsh tone while being redirected after being told to “get off the table”. Today, I observed children being attended to in a nurturing and appropriate manner and in keeping with the children’s developmental needs. I observed staff praise, reward, and encourage the children. I observed staff reason with and set limits for the children. I observed staff model appropriate behavior for the children. I observed staff listen to the children. I observed staff provide alternatives for inappropriate behavior to the children. I observed staff provide the children with natural and logical consequences of their behaviors. I observed staff treat the children as people and respect their needs, desires, and feelings. I observed staff ignore minor misbehaviors. I observed staff explain things to children on their level. I observed staff stay consistent in our behavior management program. I observed staff use effective guidance and behavior management techniques that focus on the child’s development. Based on interviews with staff, the allegation that children were not attended to in a nurturing and appropriate manner or in keeping with the children’s developmental needs was substantiated. The following violation was observed and cited today: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. One two-year-old child was spoken to in a harsh and loud tone while being redirected to get off a table on which the child had climbed. G.S. 110-91(10) Compliance Plan: All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. I must receive your compliance letter no later than August 9, 2022. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Kimberly Crane Post Office Box 6217 Hickory, NC 28603 For your convenience, your compliance letter may be sent by email to: kimberly.crane@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 During today’s visit, I provided the following technical assistance: 1) Children should be adequately supervised at all times which includes the following expectations: a) staff should be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (b) staff should interact with the children while moving about the indoor or outdoor area; (c) staff should know where each child is located and be aware of the children's activities at all times; (d) staff should provide supervision appropriate to the individual age, needs, and capabilities of each child; and (e) staff should be able to see and hear children aged birth to five years old while the children are eating. 2) Children should be cared for in a nurturing and caring manner at all times. No child should be handled roughly, shamed, humiliated, threatened, yelled at, bullied by staff, or spoken to in a loud and/or harsh tone in any way under any circumstances. 3) I suggested you require your morning and afternoon staff to participate in training to prepare for the environmental rating scale observations and evaluations. 4) I suggested you share the NC Rated License Assessment Project (NCRLAP) website with your staff and assist them in locating training videos focused on positive interactions with children, nurturing care, and appropriate tone of voice. 5) Today, I spent time in the classrooms modeling appropriate interactions, tone of voice, and redirection techniques to use with young children. 6) I suggested you request training for your staff to review the use of nurturing and caring phrases in place of direct commands which may often be perceived as being less nurturing and caring. 7) I suggested you develop a procedure for better communication between the morning shift and the afternoon/evening shift that provides the afternoon/evening shift with the details surrounding incidents of biting and other recurring negative behavior. Having the details will equip the afternoon/evening shift with the information they need to answer parent questions and concerns when the child is picked up. 8) I suggested you provide parents with resources that help them understand that while biting is a “typical” behavior for one and two-year-old children in group care, it is not an appropriate or acceptable behavior. Early childhood educators work on a daily basis to teach young children alternate ways for communicating their needs and emotions. The success of any early childhood program depends greatly on the partnership between the parents and the teachers who work together to provide the best possible care for each child. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. Please continue e visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (828) 493-6390 or by email at kimberly.crane@dhhs.nc.gov or my supervisor, Kris Updike, by email at kris.updike@dhhs.nc.gov. Thank you for your time today. 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