Ymca Marion Afterschool

NC GS 110-90 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/11/2026 Number Present: 12 Completed Date: 2/11/2026 Age: From 5 To 11 Total Minutes: 125 Time In: 02:10 PM Time Out: 04:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit, including health and safety. The visit was conducted with you, Kimberly Burleson, Program Coordinator. Amy Deter, YMCA Administrative staff joined via Teams meeting to review staff file information. This program currently operates with a Five Star license issued on September 13, 2024. The permit restrictions include 1st shift, school age only, enhanced ratios, enhanced space, and playground doesn’t meet childcare playground safety standards. We discussed that removal of the restriction playground area does not meet child care safety standards is needed per Session Law 2025-36. A permit change packet will be completed and sent in to the Raleigh office. Once you receive the new license in the mail, you will take down the previous license and post the new license. When you remove the previous license, you will mail it to me as it is property of the State and must be mailed into the Raleigh office. The last annual compliance visit was conducted February 27, 2025. The most recent monthly fire drill was conducted on January 30, 2026. The most recent quarterly lockdown drill was conducted on October 7, 2025. The facilities EPR Plan was reviewed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 99 percent as of February 9, 2026. The NC Secretary of State website was reviewed on February 9, 2026 and The Young Men's Christian Association of Western North Carolina, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. Space used during today’s visit for this school-age only program operating in a DPI program were monitored. You are currently using Space # 4 (Room 115) for your indoor classroom. The outdoor space used was the elementary school playground outside of Room 115. I observed children in the indoor learning environment and found supervision and staff/child ratios in compliance. Children were participating in handwashing routines, group story time, and snack. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. You provided me with applicable program, staff, and children’s records for review. One existing staff file and applicable records for all staff were reviewed. No new staff have been hired since the last monitoring visit. All staff were listed on the YMCA West Marion Afterschool ABCMS Provider Portal roster for this facility. A sample of two children’s records were reviewed. The following violation was observed: Violation Number Comment Rule 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last documented lock down drill was conducted October 7, 2025. .0604(u);.0302(d)(8) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before February 25, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant PO Box 64 Rutherfordton, NC 28139 beth.archer@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: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: Shelter-in-Place or Lockdown drills must be completed at least once every three (3) months. I suggested you create calendar reminders at least one year in advance to ensure drills are conducted at least once every three (3) months. I suggested you document the drill immediately after the drill is conducted to ensure required documentation is on file and available for review. Continue to document drills on the drill log form found on the DCDEE website. Consultation: I monitored YMCA bus B-10 for transportation requirements. Tire tread on the back tires was moderately worn and should be monitored for replacement when needed. The ABCMS provider portal facility roster should be updated in ABCMS on 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. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. We discussed Pathway #1, #2, and #3. The program completed a rated license reassessment on September 13, 2024. You will be required to complete a new rated license reassessment before September 13, 2027. I encouraged you to review the QRIS information more thoroughly by visiting https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization. I reminded you to make sure each staff person has registered for a WORKS account, submitted an official transcript if applicable) and/or a copy of their BSAC certificate, and have applied for a position for evaluation. Currently, the Program Coordinator had an incomplete WORKS account, and the Group Leader did not have an established account in WORKS. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Beth Archer Child Care Consultant 828-748-7893 Beth.Archer@dhhs.nc.gov or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 9/25/2025 Number Present: 14 Completed Date: 9/25/2025 Age: From 5 To 10 Total Minutes: 115 Time In: 01:55 PM Time Out: 03:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements, including health and safety. The visit was conducted with you, Kimberly Burleson, Program Coordinator. You provided me with applicable program records for review. Amy Deter, YMCA Administrative Staff also joined via Teams meeting to provide staff record’s information. The NC Secretary of State website was reviewed on September 15, 2025 and The Young Men’s Christian Association of Western North Carolina, Inc. was listed as current/active. This program currently operates with a Five star rated license effective September 13, 2024. The permit restrictions were in compliance including 1st shift, School age only, meets enhanced ratios, meets enhanced space, and playground doesn’t meet childcare playground safety standards. The program’s compliance history was 99 percent prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment and found supervision and staff/child ratios in compliance. Children and staff were participating in group art activities, handwashing protocols, and snack. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, and Special Training. The last monthly fire drill was practiced on September 15, 2025. The last lockdown drill was practiced on August 29, 2025. The following violation was observed today: Violation Number Comment Rule 1914 The person identified as the person or alternate person responsible for carrying out the emergency medical care plan was not on the premises at all times and/or did not accompany children for off premise activities. The person/alternate person responsible for contacting a medical resource, person/alternate person in center responsible for determining appropriate transportation, a person/alternate person in center responsible for notifying the medical facility about the ill/injured child being transported for treatment, and the person/alternate person in center responsible for notification of parents or emergency contact of illness/accident was not on premises. .0802(b)(1-2) The violation(s) documented must be corrected immediately. On or before October 9, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Please send the information to beth.archer@dhhs.nc.gov Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: The person identified as the person or alternate person responsible for carrying out the emergency medical care plan must on the premises at all times. Your emergency medical care plan dated 8/22/25, had a listed person/alternate person responsible for contacting a medical resource, a listed person/alternate person in center responsible for determining appropriate transportation, a listed person/alternate person in center responsible for notifying the medical facility about the ill/injured child being transported for treatment, and a listed person/alternate person in center responsible for notification of parents or emergency contact of illness/accident that was not on premises. Since your staff rotates to different sites, I suggest that you list multiple staff members as a person or alternate for emergency care, to ensure that someone is always on premises. Consultation or other topics discussed today: Child care providers, including the director, uncompensated providers, substitute providers, and volunteers, must have an Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional on file and available for review. Since staff have limited access to the virtual staff records and staff rotate to multiple sites, I suggest that staff either carry their current emergency information form from one site to another or a copy of each employees' emergency form be kept at each site. We reviewed your ABCMS provider portal facility roster. All current employees are listed on the roster. This information should be updated in ABCMS on 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. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGallaird@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1003 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .803 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09. 1003 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09. 2510 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0304 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0801 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0803 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 3/6/2024 Number Present: 9 Completed Date: 3/6/2024 Age: From 5 To 9 Total Minutes: 215 Time In: 02:00 PM Time Out: 05:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. You, Angela Strickland, Program Director, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only, meets enhanced ratios, and playground does not meet child care playground safety. The Secretary of State website was checked on March 6, 2024 and your business THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA, INC. is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. You confirmed the following as your current email address: yba@ymcawnc.org. Email and ncchildcare.nc.gov are the primary means of communication from the Division’s main office. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children were participating in snack time, transitions and free play in activity areas. The center's compliance history was at 96% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of two children’s files were reviewed. One new staff file was reviewed. A sample of one existing staff file was reviewed. The last monthly fire drill was practiced on 2/18/24. The last lockdown drill was practiced on 12/4/23. The most recent sanitation inspection for your facility was conducted on November 17, 2023. A superior sanitation classification was issued with no demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In Space #4, there was one EPI pen that was not in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization.One prescription Ventolin HFA inhaler had a medication authorization that expired 2/1/24. .0803(12) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs available with the children’s emergency and identifying information for the children being transported. 10A NCAC 09 .1003(d) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. One child with a prescription Ventolin HFA inhaler, did not have a medical action plan on file for the child’s chronic condition. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. One staff member employed 10/28/23, had not completed the Recognizing and Responding to Suspicions of Child Maltreatment training. .1102(g) 1921 Staff working in part-time, full-day or track out school age care programs required to complete BSAC training, did not complete it within three months of employment. One staff member employed 10/28/23, had not completed BSAC training. .2510(j) The violation(s) documented must be corrected immediately. On or before March 20, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item #844 Prescribed medicine must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a). We discussed that you need to have a conversation with parents to inform them that pharmacy label information must be obtained in order to verify that the medication was prescribed for a particular child and the pharmacy instructions for usage. Item #849 Medications must be returned to the parent or discarded within 72 hours after the authorization has expired. 10A NCAC 09 .803(12). We discussed that prescription medication may be authorized for up to six months for chronic conditions. Item #1124 Emergency and identifying information, including the child’s photograph, must be in the vehicle for each child being transported. 10A NCAC 09. 1003(d). You reported that you have photographs of all of the children that you will print out and attach to the identifying information in the bus notebook. Item #1834 A medical action plan must be completed for any child with health care needs for a chronic condition. 10A NCAC 09.0801(b). Emergency medications would be prescribed for chronic conditions. A medical action plan must be created for the child with an emergency inhaler. A sample medical action plan is available on the DCDEE website under provider documents/forms. Item #1897 All staff must complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102(g). We discussed that the staff member has not yet completed this training due to some absences from work for schooling but will complete the needed training in the next 2 weeks. Item #1921 Staff working with school age care programs are required to complete BSAC training within three months of employment. 10A NCAC 09. 2510(j). You reported that the staff member employed 10/28/23, has partially completed this training on-line but has not yet finished the training. This training must be completed within the next 2 weeks. Consultation or other topics discussed today: Per 10A NCAC 09.0304, The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. If the fire inspection report is not submitted to your Child Care Consultant within one week after the fire inspection is conducted, a violation will be cited during the facilities next monitoring visit. A copy of the Application for Assessment for a Two Component Star Rated License was given to you during today’s visit. You completed this form and gave it to me during the visit. You completed the Rated License Assessment Request Review Form. We discussed you are ready to order the Environment Rating Scale for the SACERS-R assessment. You stated, and I observed, that you have one (1) room for school-age children. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. NCRLAP also offers Webinar trainings for staff. I would recommend that you register now for the upcoming Webinar trainings listed on the ncrlap.org website. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0801 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 12/1/2023 Number Present: 11 Completed Date: 12/1/2023 Age: From 5 To 10 Total Minutes: 125 Time In: 02:25 PM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced routine unannounced visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival, the purpose of today’s visit was reviewed with you, Angela Strickland, Program Director. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only and playground does not meet child care standards. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in the indoor learning environment and found supervision and staff/child ratios in compliance. Children throughout the facility were participating in art activities and snack time. The center's compliance history prior to today’s visit was reviewed with the operator. The program’s compliance history was 98 percent as of November 22, 2023. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. One new staff member was hired and one staff member has been reassigned to this program since the annual compliance visit April 24, 2023. Both staff files were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Special Training including Health and Safety Training and Criminal Background Checks. Transportation was monitored as transportation is now being offered at this program. The most recent sanitation inspection for your facility was conducted on March 6, 2023. A supervisor sanitation classification was issued with three demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One EpiPen Jr. was not in the original pharmacy labeled container. .0803(2)(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. A medical action plan for an EpiPen Jr was last updated on 9/27/22. .0801(b) The violation(s) documented must be corrected immediately. On or before December 15, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: Pharmacy Packaging: Prescribed medicines must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a) Medical Action Plan: The medical action plan must be updated on an annual basis or when changes are made to the plan. 10A NCAC 09.0801(b)(1-4) Consultation or other topics discussed today: We discussed that first aid kits should not contain any ointments, as parental permission must be given for any topical ointment to be administered. You removed the ointments in the First Aid kit and threw them away. Your facility in in Cohort 1 with a preparatory year of July 1, 2023-June 30, 2024 and an assessment year of July 1, 2024-June 30, 2025. We discussed that you are planning to completing an ERS during the preparatory year. Please contact me as soon as you are order for the scales to be ordered. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was emailed to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0803 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 12/1/2023 Number Present: 11 Completed Date: 12/1/2023 Age: From 5 To 10 Total Minutes: 125 Time In: 02:25 PM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced routine unannounced visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival, the purpose of today’s visit was reviewed with you, Angela Strickland, Program Director. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only and playground does not meet child care standards. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in the indoor learning environment and found supervision and staff/child ratios in compliance. Children throughout the facility were participating in art activities and snack time. The center's compliance history prior to today’s visit was reviewed with the operator. The program’s compliance history was 98 percent as of November 22, 2023. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. One new staff member was hired and one staff member has been reassigned to this program since the annual compliance visit April 24, 2023. Both staff files were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Special Training including Health and Safety Training and Criminal Background Checks. Transportation was monitored as transportation is now being offered at this program. The most recent sanitation inspection for your facility was conducted on March 6, 2023. A supervisor sanitation classification was issued with three demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One EpiPen Jr. was not in the original pharmacy labeled container. .0803(2)(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. A medical action plan for an EpiPen Jr was last updated on 9/27/22. .0801(b) The violation(s) documented must be corrected immediately. On or before December 15, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: Pharmacy Packaging: Prescribed medicines must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a) Medical Action Plan: The medical action plan must be updated on an annual basis or when changes are made to the plan. 10A NCAC 09.0801(b)(1-4) Consultation or other topics discussed today: We discussed that first aid kits should not contain any ointments, as parental permission must be given for any topical ointment to be administered. You removed the ointments in the First Aid kit and threw them away. Your facility in in Cohort 1 with a preparatory year of July 1, 2023-June 30, 2024 and an assessment year of July 1, 2024-June 30, 2025. We discussed that you are planning to completing an ERS during the preparatory year. Please contact me as soon as you are order for the scales to be ordered. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was emailed to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: YMCA MARION AFTERSCHOOL Facility ID: 59000152 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 12/1/2023 Number Present: 11 Completed Date: 12/1/2023 Age: From 5 To 10 Total Minutes: 125 Time In: 02:25 PM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced routine unannounced visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival, the purpose of today’s visit was reviewed with you, Angela Strickland, Program Director. Your program currently operates with a three star license effective March 1, 2018. The permit restrictions were in compliance including 1st shift, school age only and playground does not meet child care standards. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in the indoor learning environment and found supervision and staff/child ratios in compliance. Children throughout the facility were participating in art activities and snack time. The center's compliance history prior to today’s visit was reviewed with the operator. The program’s compliance history was 98 percent as of November 22, 2023. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. One new staff member was hired and one staff member has been reassigned to this program since the annual compliance visit April 24, 2023. Both staff files were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Special Training including Health and Safety Training and Criminal Background Checks. Transportation was monitored as transportation is now being offered at this program. The most recent sanitation inspection for your facility was conducted on March 6, 2023. A supervisor sanitation classification was issued with three demerits. The most recent fire inspection for your facility was conducted on October 5, 2023. The facility was approved for day time care. The following violation(s) were observed today: Violation Number Comment Rule 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. One EpiPen Jr. was not in the original pharmacy labeled container. .0803(2)(a) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. A medical action plan for an EpiPen Jr was last updated on 9/27/22. .0801(b) The violation(s) documented must be corrected immediately. On or before December 15, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: Pharmacy Packaging: Prescribed medicines must be in the original pharmacy labeled container. 10A NCAC 09.0803(2)(a) Medical Action Plan: The medical action plan must be updated on an annual basis or when changes are made to the plan. 10A NCAC 09.0801(b)(1-4) Consultation or other topics discussed today: We discussed that first aid kits should not contain any ointments, as parental permission must be given for any topical ointment to be administered. You removed the ointments in the First Aid kit and threw them away. Your facility in in Cohort 1 with a preparatory year of July 1, 2023-June 30, 2024 and an assessment year of July 1, 2024-June 30, 2025. We discussed that you are planning to completing an ERS during the preparatory year. Please contact me as soon as you are order for the scales to be ordered. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was emailed to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times