10A NCAC 09 .0304 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/18/2024 Number Present: 6 Completed Date: 7/18/2024 Age: From 3 To 3 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to this Early Head Start program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher/on-site 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. Rose and explained the reason for my visit. There were no new teachers at this facility today, so no staff files were monitored today. There are eight (8) children enrolled and six (6) present today. No 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 License Posted- Five (5) star license, effective 10/28/19. Permit Restrictions- Daytime care only, meeting reduced ratios and meeting enhanced space. The last fire drill was practiced on 6/19/24. A lock down drill was conducted on 5/24/24. The last fire inspection was 7/25/23. This is due one week from today. The last sanitation inspection was completed on 11/29/23 with two (2) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. When I arrived, children were lining up to go outside to play. I followed them out so that I could monitor the playground. I observed most of the children riding on riding toys around the trike path. One child was swinging with a teacher on the big swing and another child was playing on the climber. When children came in from outside, they took turns washing their hands for lunch. Today lunch consisted of ham and cheese sandwiches, lettuce and tomato, mandarin oranges and milk. Teachers sat with children to eat lunch and role model during family style dining. When children finished eating, they cleaned up, which includes going to the restroom and washing hands. They settled down on their cots for rest time. Teachers went around rubbing backs and rocking to assist children in falling asleep. This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk .2820(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A diaper cream parent authorization was older than 12 months. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: Item #1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A diaper cream parent authorization was older than 12 months. Item #840 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: The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk. 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 August 1, 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 Your facility has been placed in cohort 1. Your prep year began 7/1/23-6/30/24. Your reassessment year will be 7/1/24- 6/30/25. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. (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: • Due to high turnover, you may want to add position titles to the emergency medical care plan instead of names. • We discussed that taking the children out the back way through the staff office space is safer than going out the front, which is closer to the main road, however the office space needs to be more child proof. Especially next school year when the children will be under three years of age. • We discussed the lock options for the kitchen and how the magnetic locks would be easier, however since the cabinets are older, they may not work. • We discussed replacing the lock on the building outside. • We discussed the cohort for star rated license and how the hold harmless has been extended. You can apply for your star rated license at any time or wait for more information that is coming soon. • Please make sure that the substitute brings her file from the other center over to this facility when she is subbing. 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. 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.

10A NCAC 09 .0803 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/18/2024 Number Present: 6 Completed Date: 7/18/2024 Age: From 3 To 3 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to this Early Head Start program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher/on-site 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. Rose and explained the reason for my visit. There were no new teachers at this facility today, so no staff files were monitored today. There are eight (8) children enrolled and six (6) present today. No 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 License Posted- Five (5) star license, effective 10/28/19. Permit Restrictions- Daytime care only, meeting reduced ratios and meeting enhanced space. The last fire drill was practiced on 6/19/24. A lock down drill was conducted on 5/24/24. The last fire inspection was 7/25/23. This is due one week from today. The last sanitation inspection was completed on 11/29/23 with two (2) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. When I arrived, children were lining up to go outside to play. I followed them out so that I could monitor the playground. I observed most of the children riding on riding toys around the trike path. One child was swinging with a teacher on the big swing and another child was playing on the climber. When children came in from outside, they took turns washing their hands for lunch. Today lunch consisted of ham and cheese sandwiches, lettuce and tomato, mandarin oranges and milk. Teachers sat with children to eat lunch and role model during family style dining. When children finished eating, they cleaned up, which includes going to the restroom and washing hands. They settled down on their cots for rest time. Teachers went around rubbing backs and rocking to assist children in falling asleep. This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk .2820(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A diaper cream parent authorization was older than 12 months. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: Item #1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A diaper cream parent authorization was older than 12 months. Item #840 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: The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk. 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 August 1, 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 Your facility has been placed in cohort 1. Your prep year began 7/1/23-6/30/24. Your reassessment year will be 7/1/24- 6/30/25. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. (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: • Due to high turnover, you may want to add position titles to the emergency medical care plan instead of names. • We discussed that taking the children out the back way through the staff office space is safer than going out the front, which is closer to the main road, however the office space needs to be more child proof. Especially next school year when the children will be under three years of age. • We discussed the lock options for the kitchen and how the magnetic locks would be easier, however since the cabinets are older, they may not work. • We discussed replacing the lock on the building outside. • We discussed the cohort for star rated license and how the hold harmless has been extended. You can apply for your star rated license at any time or wait for more information that is coming soon. • Please make sure that the substitute brings her file from the other center over to this facility when she is subbing. 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/18/2024 Number Present: 6 Completed Date: 7/18/2024 Age: From 3 To 3 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to this Early Head Start program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher/on-site 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. Rose and explained the reason for my visit. There were no new teachers at this facility today, so no staff files were monitored today. There are eight (8) children enrolled and six (6) present today. No 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 License Posted- Five (5) star license, effective 10/28/19. Permit Restrictions- Daytime care only, meeting reduced ratios and meeting enhanced space. The last fire drill was practiced on 6/19/24. A lock down drill was conducted on 5/24/24. The last fire inspection was 7/25/23. This is due one week from today. The last sanitation inspection was completed on 11/29/23 with two (2) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. When I arrived, children were lining up to go outside to play. I followed them out so that I could monitor the playground. I observed most of the children riding on riding toys around the trike path. One child was swinging with a teacher on the big swing and another child was playing on the climber. When children came in from outside, they took turns washing their hands for lunch. Today lunch consisted of ham and cheese sandwiches, lettuce and tomato, mandarin oranges and milk. Teachers sat with children to eat lunch and role model during family style dining. When children finished eating, they cleaned up, which includes going to the restroom and washing hands. They settled down on their cots for rest time. Teachers went around rubbing backs and rocking to assist children in falling asleep. This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk .2820(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A diaper cream parent authorization was older than 12 months. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: Item #1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A diaper cream parent authorization was older than 12 months. Item #840 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: The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk. 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 August 1, 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 Your facility has been placed in cohort 1. Your prep year began 7/1/23-6/30/24. Your reassessment year will be 7/1/24- 6/30/25. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. (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: • Due to high turnover, you may want to add position titles to the emergency medical care plan instead of names. • We discussed that taking the children out the back way through the staff office space is safer than going out the front, which is closer to the main road, however the office space needs to be more child proof. Especially next school year when the children will be under three years of age. • We discussed the lock options for the kitchen and how the magnetic locks would be easier, however since the cabinets are older, they may not work. • We discussed replacing the lock on the building outside. • We discussed the cohort for star rated license and how the hold harmless has been extended. You can apply for your star rated license at any time or wait for more information that is coming soon. • Please make sure that the substitute brings her file from the other center over to this facility when she is subbing. 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/18/2024 Number Present: 6 Completed Date: 7/18/2024 Age: From 3 To 3 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to this Early Head Start program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher/on-site 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. Rose and explained the reason for my visit. There were no new teachers at this facility today, so no staff files were monitored today. There are eight (8) children enrolled and six (6) present today. No 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 License Posted- Five (5) star license, effective 10/28/19. Permit Restrictions- Daytime care only, meeting reduced ratios and meeting enhanced space. The last fire drill was practiced on 6/19/24. A lock down drill was conducted on 5/24/24. The last fire inspection was 7/25/23. This is due one week from today. The last sanitation inspection was completed on 11/29/23 with two (2) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. When I arrived, children were lining up to go outside to play. I followed them out so that I could monitor the playground. I observed most of the children riding on riding toys around the trike path. One child was swinging with a teacher on the big swing and another child was playing on the climber. When children came in from outside, they took turns washing their hands for lunch. Today lunch consisted of ham and cheese sandwiches, lettuce and tomato, mandarin oranges and milk. Teachers sat with children to eat lunch and role model during family style dining. When children finished eating, they cleaned up, which includes going to the restroom and washing hands. They settled down on their cots for rest time. Teachers went around rubbing backs and rocking to assist children in falling asleep. This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk .2820(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A diaper cream parent authorization was older than 12 months. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: Item #1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A diaper cream parent authorization was older than 12 months. Item #840 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: The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk. 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 August 1, 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 Your facility has been placed in cohort 1. Your prep year began 7/1/23-6/30/24. Your reassessment year will be 7/1/24- 6/30/25. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. (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: • Due to high turnover, you may want to add position titles to the emergency medical care plan instead of names. • We discussed that taking the children out the back way through the staff office space is safer than going out the front, which is closer to the main road, however the office space needs to be more child proof. Especially next school year when the children will be under three years of age. • We discussed the lock options for the kitchen and how the magnetic locks would be easier, however since the cabinets are older, they may not work. • We discussed replacing the lock on the building outside. • We discussed the cohort for star rated license and how the hold harmless has been extended. You can apply for your star rated license at any time or wait for more information that is coming soon. • Please make sure that the substitute brings her file from the other center over to this facility when she is subbing. 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/18/2024 Number Present: 6 Completed Date: 7/18/2024 Age: From 3 To 3 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to this Early Head Start program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher/on-site 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. Rose and explained the reason for my visit. There were no new teachers at this facility today, so no staff files were monitored today. There are eight (8) children enrolled and six (6) present today. No 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 License Posted- Five (5) star license, effective 10/28/19. Permit Restrictions- Daytime care only, meeting reduced ratios and meeting enhanced space. The last fire drill was practiced on 6/19/24. A lock down drill was conducted on 5/24/24. The last fire inspection was 7/25/23. This is due one week from today. The last sanitation inspection was completed on 11/29/23 with two (2) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. When I arrived, children were lining up to go outside to play. I followed them out so that I could monitor the playground. I observed most of the children riding on riding toys around the trike path. One child was swinging with a teacher on the big swing and another child was playing on the climber. When children came in from outside, they took turns washing their hands for lunch. Today lunch consisted of ham and cheese sandwiches, lettuce and tomato, mandarin oranges and milk. Teachers sat with children to eat lunch and role model during family style dining. When children finished eating, they cleaned up, which includes going to the restroom and washing hands. They settled down on their cots for rest time. Teachers went around rubbing backs and rocking to assist children in falling asleep. This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk .2820(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A diaper cream parent authorization was older than 12 months. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: Item #1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A diaper cream parent authorization was older than 12 months. Item #840 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: The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk. 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 August 1, 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 Your facility has been placed in cohort 1. Your prep year began 7/1/23-6/30/24. Your reassessment year will be 7/1/24- 6/30/25. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. (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: • Due to high turnover, you may want to add position titles to the emergency medical care plan instead of names. • We discussed that taking the children out the back way through the staff office space is safer than going out the front, which is closer to the main road, however the office space needs to be more child proof. Especially next school year when the children will be under three years of age. • We discussed the lock options for the kitchen and how the magnetic locks would be easier, however since the cabinets are older, they may not work. • We discussed replacing the lock on the building outside. • We discussed the cohort for star rated license and how the hold harmless has been extended. You can apply for your star rated license at any time or wait for more information that is coming soon. • Please make sure that the substitute brings her file from the other center over to this facility when she is subbing. 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. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/18/2024 Number Present: 6 Completed Date: 7/18/2024 Age: From 3 To 3 Total Minutes: 180 Time In: 10:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to this Early Head Start program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher/on-site 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. Rose and explained the reason for my visit. There were no new teachers at this facility today, so no staff files were monitored today. There are eight (8) children enrolled and six (6) present today. No 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 License Posted- Five (5) star license, effective 10/28/19. Permit Restrictions- Daytime care only, meeting reduced ratios and meeting enhanced space. The last fire drill was practiced on 6/19/24. A lock down drill was conducted on 5/24/24. The last fire inspection was 7/25/23. This is due one week from today. The last sanitation inspection was completed on 11/29/23 with two (2) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. When I arrived, children were lining up to go outside to play. I followed them out so that I could monitor the playground. I observed most of the children riding on riding toys around the trike path. One child was swinging with a teacher on the big swing and another child was playing on the climber. When children came in from outside, they took turns washing their hands for lunch. Today lunch consisted of ham and cheese sandwiches, lettuce and tomato, mandarin oranges and milk. Teachers sat with children to eat lunch and role model during family style dining. When children finished eating, they cleaned up, which includes going to the restroom and washing hands. They settled down on their cots for rest time. Teachers went around rubbing backs and rocking to assist children in falling asleep. This facility does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk .2820(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A diaper cream parent authorization was older than 12 months. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: Item #1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A diaper cream parent authorization was older than 12 months. Item #840 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: The cleaners under the sink in the kitchen need to be locked with an approved lock which includes lock/key, combination lock or magnetic lock. This is especially important since the children walked by the kitchen entrance to go to/from the playground. The storage building outside has a bucket of paint inside, however the pad lock was not locked due to no key. Children walked through the office area to go to/from the playground. A container of aerosol snack cheese (cheese whizz) was on a teacher’s desk. 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 August 1, 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 Your facility has been placed in cohort 1. Your prep year began 7/1/23-6/30/24. Your reassessment year will be 7/1/24- 6/30/25. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. (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: • Due to high turnover, you may want to add position titles to the emergency medical care plan instead of names. • We discussed that taking the children out the back way through the staff office space is safer than going out the front, which is closer to the main road, however the office space needs to be more child proof. Especially next school year when the children will be under three years of age. • We discussed the lock options for the kitchen and how the magnetic locks would be easier, however since the cabinets are older, they may not work. • We discussed replacing the lock on the building outside. • We discussed the cohort for star rated license and how the hold harmless has been extended. You can apply for your star rated license at any time or wait for more information that is coming soon. • Please make sure that the substitute brings her file from the other center over to this facility when she is subbing. 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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.

10A NCAC 09 .0604 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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 .0605 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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

GS 110-91 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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

NC GS 110-90 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/14/2024 Number Present: 6 Completed Date: 2/14/2024 Age: From 2 To 3 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during the visit. An electronic signed copy of the visit summary was emailed to you. Upon my arrival, I greeted the teachers and children and explained the reason for today’s visit. Ronda Rose, lead teacher, was available to answer all my questions and assist me during today’s visit. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-eight (88%) percentage as of 02/14/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the non-profit corporation, Intermountain Children’s Services, Inc, is current/active as of 02/14/24. Permit type – Five (5) star license, issued on October 28, 2019. Special Services/Restrictions – Daytime care only, Meeting reduced ratios and enhanced space. The last annual compliance visit was conducted on 02/22/23. The last fire drill was practiced on 02/09/24. The last shelter-in-place drill was practiced on 12/07/23. The last playground inspection was documented on 02/01/24. The last fire inspection was approved on 07/25/23. The last sanitation inspection was conducted on 11/29/23 with two (2) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Response and Preparedness Plan was current and updated as of 07/02/23. The approved curriculum for four-year-old children is Upon arrival I greeted the teachers and children. The children were excited to show me their valentine’s day boxes that they had made at home with their parents for their valentines. They told me all about the strawberry cookies that they had made earlier. Children were pretending to cook various items such as asparagus, and salad. Some children were building with blocks and playing with a fire truck. During my observation, I witnessed children taking care of their bodies by wiping their noses, washing hands and using the potty. After cleaning up, the children went outside to play on the playground. Once they came inside, they washed hands and prepared to eat lunch. Lunch today consisted of turkey and cheese on whole grain bread (sandwich), optional mayonnaise, raw broccoli with optional ranch dressing, mandarin oranges and milk. After luch, children settled down on their cots to rest. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The playground fence was less than four (4) feet in several places throughout the play yard. GS 110-91(6); .0605((i) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. .0604(q) Technical assistance was provided as follows: Item #824 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: The playground fence was less than four (4) feet in several places throughout the play yard. Item #858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: The diaper changing area had plastic items below five (5) feet. There is a gate separating this area, however the gate lock was broken preventing it from being opened by children. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 28, 2024. Email the compliance letter on signed letterhead or in 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 it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Sheets on cots should not touch each other. • Items should not be stored on cots. • Assure that trash cans are emptied of the water in them. • Toy bins on the playground should be free of standing water as well as the flower pots in the front of the building. Perhaps drilling draining holes in the bottom will prevent standing water. 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 a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 10/23/2023 Number Present: 7 Completed Date: 10/23/2023 Age: From 2 To 3 Total Minutes: 165 Time In: 10:15 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. This is an Early Head Start Facility with only one classroom. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during my visit. An electronic signed copy of the visit summary was electronically emailed to Ms. Rose. Upon my arrival I greeted the teachers and children and explained the reason for my visit. Children were playing outside on the playground when I arrived. They were playing in the sand, climbing, sliding, riding tikes and other activities. I went inside to monitor the classroom areas and postings. The children came inside about 11:30. They put away their coats, washed hands and sat down for lunch. Lunch today consisted on chicken wraps (which was baked chicken, spinach salad on a whole grain wrap with sour cream and or ranch dressing), pineapples and milk. There are no new teachers, so no files were monitored today. They are still trying to find and keep the second cook hired. 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 License Posted- Five star license issued October 28, 2019. Permit Restrictions- Daytime care only, meeting reduced ratios and enhanced space. The last fire drill was practiced 9/19/23. An emergency drill was conducted on 9/7/23. The last fire inspection was 7/25/23. The last sanitation inspection was completed on 8/12/22 with zero (0) demerits for a superior rating. This inspection is over two months past due. The Environmental Health Specialist has bee contacted by the provider and the consultant. He has stated he can get the inspection completed the first week of November. The Emergency Medical Care Plan is posted, but it does need to be updated. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection is over two (2) months past due. 10A NCAC 09 .0304(b) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. .0605(g) Technical assistance: Item #. 0104 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. Note: The sanitation inspection is over two (2) months past due. Item #.0714 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. Note: There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. 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 November 6, 2023. 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: • Today we discussed the Star Rated License and the rating scales. I left some material for the teachers to look at with resources to help with their prep year. • We discussed the emergency medical care plan needing to be updated. • The emergency in formation and health questionnaire for staff were located together. It is important that any health documents be in a separate file marked confidential. This is a HIPPA rule. • There is a gap in the gate where the children enter the playground. The fence latches fine but the gap is 3 ¾ inches wide. We discussed adding a board to the post to close in the gap. • We discussed the corners of the wood boarders for the climbing/mulched area. The corners are fairly sharp and need to be sanded down to round them off. • When checking the medication and diaper changing area, the gate fell off the wall. This needs to be replaced with one similar to the one at the kitchen or a retractable one. 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.

10A NCAC 09 .0605 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 10/23/2023 Number Present: 7 Completed Date: 10/23/2023 Age: From 2 To 3 Total Minutes: 165 Time In: 10:15 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. This is an Early Head Start Facility with only one classroom. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during my visit. An electronic signed copy of the visit summary was electronically emailed to Ms. Rose. Upon my arrival I greeted the teachers and children and explained the reason for my visit. Children were playing outside on the playground when I arrived. They were playing in the sand, climbing, sliding, riding tikes and other activities. I went inside to monitor the classroom areas and postings. The children came inside about 11:30. They put away their coats, washed hands and sat down for lunch. Lunch today consisted on chicken wraps (which was baked chicken, spinach salad on a whole grain wrap with sour cream and or ranch dressing), pineapples and milk. There are no new teachers, so no files were monitored today. They are still trying to find and keep the second cook hired. 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 License Posted- Five star license issued October 28, 2019. Permit Restrictions- Daytime care only, meeting reduced ratios and enhanced space. The last fire drill was practiced 9/19/23. An emergency drill was conducted on 9/7/23. The last fire inspection was 7/25/23. The last sanitation inspection was completed on 8/12/22 with zero (0) demerits for a superior rating. This inspection is over two months past due. The Environmental Health Specialist has bee contacted by the provider and the consultant. He has stated he can get the inspection completed the first week of November. The Emergency Medical Care Plan is posted, but it does need to be updated. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection is over two (2) months past due. 10A NCAC 09 .0304(b) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. .0605(g) Technical assistance: Item #. 0104 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. Note: The sanitation inspection is over two (2) months past due. Item #.0714 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. Note: There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. 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 November 6, 2023. 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: • Today we discussed the Star Rated License and the rating scales. I left some material for the teachers to look at with resources to help with their prep year. • We discussed the emergency medical care plan needing to be updated. • The emergency in formation and health questionnaire for staff were located together. It is important that any health documents be in a separate file marked confidential. This is a HIPPA rule. • There is a gap in the gate where the children enter the playground. The fence latches fine but the gap is 3 ¾ inches wide. We discussed adding a board to the post to close in the gap. • We discussed the corners of the wood boarders for the climbing/mulched area. The corners are fairly sharp and need to be sanded down to round them off. • When checking the medication and diaper changing area, the gate fell off the wall. This needs to be replaced with one similar to the one at the kitchen or a retractable one. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 10/23/2023 Number Present: 7 Completed Date: 10/23/2023 Age: From 2 To 3 Total Minutes: 165 Time In: 10:15 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. This is an Early Head Start Facility with only one classroom. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during my visit. An electronic signed copy of the visit summary was electronically emailed to Ms. Rose. Upon my arrival I greeted the teachers and children and explained the reason for my visit. Children were playing outside on the playground when I arrived. They were playing in the sand, climbing, sliding, riding tikes and other activities. I went inside to monitor the classroom areas and postings. The children came inside about 11:30. They put away their coats, washed hands and sat down for lunch. Lunch today consisted on chicken wraps (which was baked chicken, spinach salad on a whole grain wrap with sour cream and or ranch dressing), pineapples and milk. There are no new teachers, so no files were monitored today. They are still trying to find and keep the second cook hired. 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 License Posted- Five star license issued October 28, 2019. Permit Restrictions- Daytime care only, meeting reduced ratios and enhanced space. The last fire drill was practiced 9/19/23. An emergency drill was conducted on 9/7/23. The last fire inspection was 7/25/23. The last sanitation inspection was completed on 8/12/22 with zero (0) demerits for a superior rating. This inspection is over two months past due. The Environmental Health Specialist has bee contacted by the provider and the consultant. He has stated he can get the inspection completed the first week of November. The Emergency Medical Care Plan is posted, but it does need to be updated. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection is over two (2) months past due. 10A NCAC 09 .0304(b) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. .0605(g) Technical assistance: Item #. 0104 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. Note: The sanitation inspection is over two (2) months past due. Item #.0714 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. Note: There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. 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 November 6, 2023. 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: • Today we discussed the Star Rated License and the rating scales. I left some material for the teachers to look at with resources to help with their prep year. • We discussed the emergency medical care plan needing to be updated. • The emergency in formation and health questionnaire for staff were located together. It is important that any health documents be in a separate file marked confidential. This is a HIPPA rule. • There is a gap in the gate where the children enter the playground. The fence latches fine but the gap is 3 ¾ inches wide. We discussed adding a board to the post to close in the gap. • We discussed the corners of the wood boarders for the climbing/mulched area. The corners are fairly sharp and need to be sanded down to round them off. • When checking the medication and diaper changing area, the gate fell off the wall. This needs to be replaced with one similar to the one at the kitchen or a retractable one. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 10/23/2023 Number Present: 7 Completed Date: 10/23/2023 Age: From 2 To 3 Total Minutes: 165 Time In: 10:15 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. This is an Early Head Start Facility with only one classroom. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during my visit. An electronic signed copy of the visit summary was electronically emailed to Ms. Rose. Upon my arrival I greeted the teachers and children and explained the reason for my visit. Children were playing outside on the playground when I arrived. They were playing in the sand, climbing, sliding, riding tikes and other activities. I went inside to monitor the classroom areas and postings. The children came inside about 11:30. They put away their coats, washed hands and sat down for lunch. Lunch today consisted on chicken wraps (which was baked chicken, spinach salad on a whole grain wrap with sour cream and or ranch dressing), pineapples and milk. There are no new teachers, so no files were monitored today. They are still trying to find and keep the second cook hired. 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 License Posted- Five star license issued October 28, 2019. Permit Restrictions- Daytime care only, meeting reduced ratios and enhanced space. The last fire drill was practiced 9/19/23. An emergency drill was conducted on 9/7/23. The last fire inspection was 7/25/23. The last sanitation inspection was completed on 8/12/22 with zero (0) demerits for a superior rating. This inspection is over two months past due. The Environmental Health Specialist has bee contacted by the provider and the consultant. He has stated he can get the inspection completed the first week of November. The Emergency Medical Care Plan is posted, but it does need to be updated. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection is over two (2) months past due. 10A NCAC 09 .0304(b) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. .0605(g) Technical assistance: Item #. 0104 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. Note: The sanitation inspection is over two (2) months past due. Item #.0714 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. Note: There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. 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 November 6, 2023. 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: • Today we discussed the Star Rated License and the rating scales. I left some material for the teachers to look at with resources to help with their prep year. • We discussed the emergency medical care plan needing to be updated. • The emergency in formation and health questionnaire for staff were located together. It is important that any health documents be in a separate file marked confidential. This is a HIPPA rule. • There is a gap in the gate where the children enter the playground. The fence latches fine but the gap is 3 ¾ inches wide. We discussed adding a board to the post to close in the gap. • We discussed the corners of the wood boarders for the climbing/mulched area. The corners are fairly sharp and need to be sanded down to round them off. • When checking the medication and diaper changing area, the gate fell off the wall. This needs to be replaced with one similar to the one at the kitchen or a retractable one. 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 HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 10/23/2023 Number Present: 7 Completed Date: 10/23/2023 Age: From 2 To 3 Total Minutes: 165 Time In: 10:15 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. This is an Early Head Start Facility with only one classroom. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during my visit. An electronic signed copy of the visit summary was electronically emailed to Ms. Rose. Upon my arrival I greeted the teachers and children and explained the reason for my visit. Children were playing outside on the playground when I arrived. They were playing in the sand, climbing, sliding, riding tikes and other activities. I went inside to monitor the classroom areas and postings. The children came inside about 11:30. They put away their coats, washed hands and sat down for lunch. Lunch today consisted on chicken wraps (which was baked chicken, spinach salad on a whole grain wrap with sour cream and or ranch dressing), pineapples and milk. There are no new teachers, so no files were monitored today. They are still trying to find and keep the second cook hired. 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 License Posted- Five star license issued October 28, 2019. Permit Restrictions- Daytime care only, meeting reduced ratios and enhanced space. The last fire drill was practiced 9/19/23. An emergency drill was conducted on 9/7/23. The last fire inspection was 7/25/23. The last sanitation inspection was completed on 8/12/22 with zero (0) demerits for a superior rating. This inspection is over two months past due. The Environmental Health Specialist has bee contacted by the provider and the consultant. He has stated he can get the inspection completed the first week of November. The Emergency Medical Care Plan is posted, but it does need to be updated. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection is over two (2) months past due. 10A NCAC 09 .0304(b) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. .0605(g) Technical assistance: Item #. 0104 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. Note: The sanitation inspection is over two (2) months past due. Item #.0714 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. Note: There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. 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 November 6, 2023. 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: • Today we discussed the Star Rated License and the rating scales. I left some material for the teachers to look at with resources to help with their prep year. • We discussed the emergency medical care plan needing to be updated. • The emergency in formation and health questionnaire for staff were located together. It is important that any health documents be in a separate file marked confidential. This is a HIPPA rule. • There is a gap in the gate where the children enter the playground. The fence latches fine but the gap is 3 ¾ inches wide. We discussed adding a board to the post to close in the gap. • We discussed the corners of the wood boarders for the climbing/mulched area. The corners are fairly sharp and need to be sanded down to round them off. • When checking the medication and diaper changing area, the gate fell off the wall. This needs to be replaced with one similar to the one at the kitchen or a retractable one. 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

G.S. 110-90 · Violation

Name of Operation: AVERY COUNTY HEAD START CENTER Facility ID: 06000043 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 10/23/2023 Number Present: 7 Completed Date: 10/23/2023 Age: From 2 To 3 Total Minutes: 165 Time In: 10:15 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. This is an Early Head Start Facility with only one classroom. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Ronda Rose, lead teacher, during my visit. An electronic signed copy of the visit summary was electronically emailed to Ms. Rose. Upon my arrival I greeted the teachers and children and explained the reason for my visit. Children were playing outside on the playground when I arrived. They were playing in the sand, climbing, sliding, riding tikes and other activities. I went inside to monitor the classroom areas and postings. The children came inside about 11:30. They put away their coats, washed hands and sat down for lunch. Lunch today consisted on chicken wraps (which was baked chicken, spinach salad on a whole grain wrap with sour cream and or ranch dressing), pineapples and milk. There are no new teachers, so no files were monitored today. They are still trying to find and keep the second cook hired. 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 License Posted- Five star license issued October 28, 2019. Permit Restrictions- Daytime care only, meeting reduced ratios and enhanced space. The last fire drill was practiced 9/19/23. An emergency drill was conducted on 9/7/23. The last fire inspection was 7/25/23. The last sanitation inspection was completed on 8/12/22 with zero (0) demerits for a superior rating. This inspection is over two months past due. The Environmental Health Specialist has bee contacted by the provider and the consultant. He has stated he can get the inspection completed the first week of November. The Emergency Medical Care Plan is posted, but it does need to be updated. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection is over two (2) months past due. 10A NCAC 09 .0304(b) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. .0605(g) Technical assistance: Item #. 0104 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. Note: The sanitation inspection is over two (2) months past due. Item #.0714 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. Note: There is a gap in the gate where the children enter the playground that measure 3 ¾ inches. 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 November 6, 2023. 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: • Today we discussed the Star Rated License and the rating scales. I left some material for the teachers to look at with resources to help with their prep year. • We discussed the emergency medical care plan needing to be updated. • The emergency in formation and health questionnaire for staff were located together. It is important that any health documents be in a separate file marked confidential. This is a HIPPA rule. • There is a gap in the gate where the children enter the playground. The fence latches fine but the gap is 3 ¾ inches wide. We discussed adding a board to the post to close in the gap. • We discussed the corners of the wood boarders for the climbing/mulched area. The corners are fairly sharp and need to be sanded down to round them off. • When checking the medication and diaper changing area, the gate fell off the wall. This needs to be replaced with one similar to the one at the kitchen or a retractable one. 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