G.S. 110-90 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-91 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: AVERY COUNTY 4-H SUMMER WOW Facility ID: 06000082 Consultant: GEORGIA MARSHALL Operation Type: Summer Day Camp Case Number: Visit Date: 7/9/2024 Number Present: 25 Completed Date: 7/9/2024 Age: From 6 To 12 Total Minutes: 240 Time In: 10:00 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Summer Day Camp Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Jennifer Woodruff, Program Administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Alicia Woodie, Program Coordinator, and explained the reason for my visit. Ms. Woodie was leaving with two (2) other group leaders, to take a group of children to the Extension Office for an activity. I observed the children leaving from the gym and loading into the Avery County 4-H van. Ms. Woodie unlocked the staff and children files for me before she left. I observed classroom #2 (space #7), which is the older children ages 9 to 12 years old. They were working on drawing their plans for a quilt square that they are later going to be putting together. I monitored the classrooms that are in use as well as the bathrooms, gym and playground area. When the van arrived, I observed them unloading and washing hands for lunch. Lunch today was baked ham, biscuit, macaroni and cheese, green beans, apple sauce and milk. There were four (4) new teachers at this facility today, however, all nine (9) staff files were monitored today. There are fifty-four (54) children enrolled and twenty five (25) present today. Six (6) children’s files were monitored during today’s visit. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records This program does provide transportation for field trips. A Chevrolet Express fifteen (15) passenger van was monitored today. Permanent tag #11190-W. This van was inspected on July 1, 2024. If both groups are transported, a public-school bus is used. License Posted- Summer Day Camp License, effective June 10, 2024 to July 26, 2024. Permit Restrictions- Daytime care only, school age children only. The last fire drill was practiced on 6/21/24. An emergency drill was conducted on 6/30/24. The last fire inspection was 5/30/24. The last sanitation inspection was completed on 5/22/24 with zero (0) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All hazardous items and those products in aerosol dispensing cans were not stored in a locked room or cabinet. Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. 15A NCAC 18A .2820(b) 841 All medicine was not kept in locked storage separate from food and cleaning supplies. Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. 15A NCAC 18A .2820(d) 842 A drug or medicine was administered without specific instructions from parent or authorized health professional. Sun screen, Benadryl and an Epi-pen did not have permission forms. 10A NCAC 09 .0803(1)(b) 1033 Prior to employment, all staff did not provide test results showing that they were free of active TB. TB test was older than 12 months. One staff (OS), had a TB screening but not a TB test, which is required in this instance. 10A NCAC 09 .0701(c) 9995 A violation was found for which there is no item number. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. 9996 A violation was found for which there is no item number. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Two children that bring packed food from home, did not have an opt out form on file. Technical assistance: Item #1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: All staff, including the director and individuals who volunteer more than once per week. Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. On or before first day of work. Note: One staff (OS), had a TB screening but not a TB test, which is required in this instance. Item #9995 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: (b) Health and safety training shall be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. One staff (AW) completed health and safety trainings over five (5) years ago and they need to be renewed. Item #9996 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. Note: Two children that bring packed food from home, did not have an opt out form on file. Items #841 and #842 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Aerosol sunscreen was at the entry table and in staff backpacks, aerosol spray was also in space #3 and in the staff bathroom. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: Sun screen and hand sanitizer was in the van, gym, staff bathroom and in space #3. Staff backpacks also have medications that must be locked. Item #842 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. Note: Sun screen, Benadryl and an Epi-pen did not have permission forms. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 23, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • We discussed that handwashing signs should be ordered and posted in each bathroom. • We also discussed that staff backpacks must be worn if they have items inside that must be kept out of reach of children. If medication or aerosol items are inside, they must be locked. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times