10A NCAC 09 .0304 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0604 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0606 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0902 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 48 Completed Date: 4/24/2025 Age: From 0 To 5 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 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. A computerized generated report of today’s visit was completed, reviewed with you, printed, and signed by me, Dawn McCrary, Child Care Consultant, and you, Suzanne White, Director, during the visit. A signed copy of the visit summary was left on site for your records. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-six (86) percentage as of 4/24/25. Permit type – Five Star Child Care License issued 4/30/24. Special Services/Restrictions – Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. Upon arrival, I made my presence known to Suzanne White, Director. Ms. White was available to assist during the visit. The following areas were monitored: Supervision Ratios CPR First Aid Criminal Record Checks Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space ITS SIDS requirements General Safety Discipline Program Records License Posted/ Permit Restrictions. During today’s visit, the classroom of one and two-year-old children were having free choice play on the playground with balls and bouncing toys. The classroom of three-year-old children were toileting, washing hands and transitioning to the outdoor playground. The classroom of four and five-year-old children were having free choice play on the playground. The classroom of three and four-year-old children were having free choice play on the playground. The classroom of two and three-year-old children were having free choice play in the classroom. The classroom of infants and one-year-old children were moving about the room freely, interacting with the caregivers, having tummy time, sleeping, and having diapers changed. The outdoor play area offers adequate space for running and vigorous play with opportunities to climb, balance, ride toys, participate in dramatic play and sand and water play. All interactions were positive. Supervision was adequate. There are eight (8) newly hired staff. The newly hired staff files were monitored for child care requirements. All staff have valid criminal background letters. One (1) emergency medication was monitored and in compliance of child care regulations. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit. Violation Number Comment Rule 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. .0902(a) 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. Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. .0604(q) 871 Center staff did not comply with the safe sleep policy. In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. 10A NCAC 09 .0606(a) Technical assistance provided as follows 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS Easily torn plastics were accessible to children in the classroom of infants and one-year-olds and the classroom of two and three-year-old children. The plastics were removed for correction during the visit. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS Seven (7) of the eight (8) feeding plans in the classroom of infants and one-year-olds did not have a parent signature. You stated that you plan to have the parents review and sign the feeding plans today. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES In the classroom of infants and one-year-olds, six (6) safe sleep 15 minute checks were not recorded for 04/23/25. Zero (0) safe sleep 15 minute checks were recorded for 04/24/25 although an infant was observed sleeping in a crib. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 05/08/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary P.O. Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. We discussed that the facility's enrollment has been started for lead based paint and asbestos. Plan to complete the survey as the next step. The lead in water test is completed. 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 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 dawn.mccrary@dhhs.nc.gov or 828-556-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1101 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: Visit Date: 11/21/2024 Number Present: 30 Completed Date: 11/21/2024 Age: From 0 To 5 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and follow-up on the supervision violation documented on 9/23/24. A computerized generated report of today’s visit was completed, reviewed with you, Tracy Pace, and signed by me, Dawn McCrary, Child Care Consultant and also signed by you, Tracy Pace, Director. Bonnie Mathis, Licensing Supervisor, accompanied me during today's visit. A signed copy of the visit summary was left on-site for you. Today, Tracy Pace, Director, was available to assist during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. The center’s compliance history was /reviewed with the operator. The program’s compliance history was eighty-three (83) percentage as of 11/20/24. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. Permit type- Five Star Child Care License; issued 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. 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 last Temporary Time Period visit was conducted on 3/27/24. The last fire drill was practiced on 11/20/24. The last shelter-in-place drill was practiced on 9/25/24. The last playground inspection was documented on 11/6/24. The last fire inspection was approved on 1/4/24. The last sanitation inspection was conducted on 8/1/24 with fifteen (15) demerits for a Superior classification. The Emergency Medical Care plan was posted and is current. The Emergency Preparedness Plan is current as of 3/27/24. The incident log was current and in use. The approved curriculum for four-year-old children is Teaching Strategies Gold. Upon our arrival, We made our presence known to Tracy Pace, Director. A walk-through of the facility was conducted. The children in space #2 were observed having free choice play in the classroom and having diapers changed. The children in space #3 were observed having large group story time. The children in space A were observed sleeping and moving freely around the classroom. The children in space B were having a large group music activity. The children transitioned to the outdoor playgrounds. They were observed playing with sand toys in the sand boxes, climbing and sliding. The outdoor playground offers many opportunities for running and vigorous play with opportunities for climbing, balancing, riding, dramatic play and ball play. The lunch served today was pasta with sauce, chicken, broccoli, mango, and milk. All interactions were positive and nurturing. Supervision was adequate. Supervision was in compliance. The supervision violation documented 9/23/24, is corrected by Consultant Visit. Thirty-three (33) children are enrolled. Four (4) children’s files were monitored for child care requirements. There are four (4) newly hired staff and five (5) existing staff. The four (4) newly hired staff’s files and two (2) existing staff file was monitored for child care requirements. The staff and training worksheet was provided and monitored during today’s visit. This program does not provide transportation. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Chipping paint was observed on the ball goal on playground 6. .0601(c) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An uncovered outlet in classroom space #1 was accessible to the children in care. 10A NCAC 09 .0604(c) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. .0802 (e) 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. Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. .0604(q) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. GS110-91(1) Technical assistance provided as follows: 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE The incident report used to document non medical injuries is recorded on a center document that does not contain all required information. Plan to use the incident report form located on DCDEE's website under Provider Documents. 110-91. Mandatory standards for a license. A medical assessment was not on file within 30 days of enrollment for one (1) child enrolled on 10/9/24. Plan to have families provide medical assessment within 30 days of enrollment. Use a calendar to track each child's 30 day deadline. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS. Electrical Outlets: Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. For this reason, all electrical outlets, including those on power strips, not in use that are in areas accessible to children must be protected with a safety plug or a tamper-resistant electrical outlet. An uncovered outlet in classroom space #1 was accessible to the children in care. An outlet cover was inserted for correction during the visit. Consider having extra outlet covers in each space, so that outlets can easily be recovered when needed. Plastic bags have been recognized for many years as a cause of suffocation. Warnings regarding this risk are printed on diaper-pail bags, dry-cleaning bags, and so forth. The U.S. Consumer Product Safety Commission (CPSC) has received average annual reports of twenty-five deaths per year to children due to suffocation from plastic bags. Nearly 90% of the reported deaths were to children under the age of one (1). Plastic wrap and a plastic bag was accessible to children under three years of age in space #1. The plastic wrap and plastic bag was placed above five feet during the visit. Plan to remind staff of the requirement of storage of plastics when children under three years of age are present. 10A NCAC 09 .0601 SAFE ENVIRONMENT. The manufacture of lead-based paint was banned in the United States in 1978, but many older buildings around the country still have it. Lead exposure during childhood can cause brain damage, loss of IQ, poor memory, behavior problems, and death. When lead-based paint breaks down, chips and dust settle onto surfaces children can easily reach, such as floors and other walking surfaces. Contaminated dust can be inhaled or ingested and is hazardous even if the particles are too small to see.5 Chipping paint was observed on the ball goal on playground 6. The ball goal was removed during the visit. Plan to do a daily check of the playgrounds for hazards. 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. Achieving Compliance: 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 12/5/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Due to Tropical Storm Helene, additional time is provided for the facility to achieve compliance for the following: 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS. Early care and education programs with staff trained in pediatric first aid and CPR can mitigate the consequences of injury and reduce the potential for death from life-threatening conditions and emergencies. Furthermore, knowledge of pediatric first aid and CPR includes addressing a blocked airway (choking) as well as rescue breathing. Repetitive training, coupled with the confidence to use these skills, are critically important to the outcome of an emergency. Three(3) staff, per the staff and training worksheet, do not have valid CPR and FA training. One (1) staff does not have any CPR or FA training. Two (2) staff have BLS training which only covers CPR. Plan to ensure at least one staff member with valid CPR and FA training is on site for the entire operating hours of the facility. You stated you are in the process of obtaining an approved training for the staff members to attend. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS. Loose-fill surfacing materials used to provide impact absorption beneath play equipment should be checked frequently to ensure surfacing is of sufficient depth and has not shifted or displaced significantly, especially in areas under swings and slide exits. Missing or displaced loose-fill surfacing should be raked back into proper place or replaced so that a constant depth is maintained throughout the playground. The mulch around and under the stationary play equipment on the playgrounds measures approximately two (2) inches due to being displaced during Tropical Storm Helene. You stated you have requested mulch delivery. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS. One (1) staff, hired 7/9/24, received five (5) of the six (6) hours of orientation required in the first two weeks of employment. Plan to provide an extra hour of training in Adequate supervision of children in accordance with 10A NCAC 09 .1801 to meet this requirement. Plan to use a tracking tool to ensure future new staff receive the adequate amount of orientation. One (1) staff, hired 7/9/24 has not completed Recognizing and Responding to Suspicions of Child Maltreatment. Plan to have the staff complete the training immediately. Plan to track training deadlines using a calendar for future new hires. Consultation provided: The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the 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 monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828-566-3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1721 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0924-200L Visit Date: 9/23/2024 Number Present: 31 Completed Date: 9/23/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 11:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by The Division of Child Development and Early Education (DCDEE) on 9/13/24 and by Dawn McCrary, Child Care Consultant, 9/13/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Tracy Pace, Director, during the visit. A signed copy of the visit summary was left on-site for you. Upon my arrival, I made my presence known to Tracy Pace, Director, and explained the reason for my visit. There are concerns regarding supervision, nurture and care. There are concerns regarding safe pick up and drop off procedures were not followed and records. Ms. Pace stated that she was aware of a staff member that was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. Ms. Pace stated that she had modeled and discussed proper supervision with the staff member in question. Ms. Pace stated that the staff member was not receptive to her supervision guidance. Ms. Pace terminated the staff member’s employment 9/11/24. During today’s visit, I monitored the classroom of one-year-olds. Supervision was adequate. I suggested installing a mirror above the diaper changing table to assist with supervising children while changing diapers. Based on Ms. Pace’s confirmation of inadequate supervision, the concern regarding supervision is substantiated. Ms. Pace stated that it was brought to her attention that the same staff member was not offering incident reports to parents/guardians at pick up. Ms. Pace had trained the staff member on the proper completion of incident reports. The staff member had completed the incident reports; however, the staff member did not offer the parents/guardians a copy. The staff member’s employment was terminated 9/11/24. During today’s visit, I monitored the facility’s incident log and incident reports from the classroom of one-year-olds. All incidents were logged. Incident reports were on-file for all logged incidents. Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parents/guardians, nor offered to the parents/guardians. Based on today’s interview and monitoring of incident reports, the concern of records not being completed as required is substantiated. Ms. Pace stated that there had been concerns about the same staff member’s interactions with parents/guardians which were not of a nurturing and caring nature. Ms. Pace stated that the staff member interacted with the children in a nurturing and caring manner and no concerns were brought to her attention of non-nurturing or caring interactions with the children. Based on today’s interview and the information received, there is insufficient evidence to support the nurture and care concern. Therefore, the concern of nurture and care is unsubstantiated. Ms. Pace stated that she was not aware of any concerns with the pick-up or drop-off of children. All staff have color copies of the identifications of persons on the children’s pick-up list. The parents/guardians enter the classrooms via a code mechanism. Ms. Pace stated that the parents/guardians of the one-year-old children are all well known to the staff. I suggested reviewing the drop-off and pick-up procedures, using the picture IDs, with staff on a regular basis, as a refresher, to ensure the children are released only to the persons identified on the pick-up list. During today’s visit, I monitored the facility’s drop-off and pick-up procedures in the family handbook. Based on the procedures I monitored, and the picture ID’s I observed, there is insufficient evidence to support the concern of safe pick-up and drop-off procedures. Therefore, the concern of safe pick-up and drop-off procedures is unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 303 Children were not adequately supervised at all times. It was confirmed that a staff member was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. .1801(a)(1-5) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parent/guardian. .0802 (e) Technical assistance provided as follows: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS #303- It was confirmed that a staff member was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. You stated that the staff member that was not adequately supervising the one-year-old children had their employment terminated 9/11/24. You stated that all staff are required to adequately supervise the children. You have modeled supervision and given guidance for supervision strategies. We discussed that a substantiated concern and violation of supervision may lead to an Administrative Action. 10A NCAC 09 .1721 REQUIREMENTS FOR RECORDS #852-Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parent/guardian. You stated that the staff are trained on the incident report procedures upon hire. You stated that the staff member not completing the incident reports as required had their employment terminated 9/11/24. Achieving Compliance: A follow-up visit will be conducted to verify compliance of violation #303 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 10/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1801 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0924-200L Visit Date: 9/23/2024 Number Present: 31 Completed Date: 9/23/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 11:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by The Division of Child Development and Early Education (DCDEE) on 9/13/24 and by Dawn McCrary, Child Care Consultant, 9/13/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Tracy Pace, Director, during the visit. A signed copy of the visit summary was left on-site for you. Upon my arrival, I made my presence known to Tracy Pace, Director, and explained the reason for my visit. There are concerns regarding supervision, nurture and care. There are concerns regarding safe pick up and drop off procedures were not followed and records. Ms. Pace stated that she was aware of a staff member that was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. Ms. Pace stated that she had modeled and discussed proper supervision with the staff member in question. Ms. Pace stated that the staff member was not receptive to her supervision guidance. Ms. Pace terminated the staff member’s employment 9/11/24. During today’s visit, I monitored the classroom of one-year-olds. Supervision was adequate. I suggested installing a mirror above the diaper changing table to assist with supervising children while changing diapers. Based on Ms. Pace’s confirmation of inadequate supervision, the concern regarding supervision is substantiated. Ms. Pace stated that it was brought to her attention that the same staff member was not offering incident reports to parents/guardians at pick up. Ms. Pace had trained the staff member on the proper completion of incident reports. The staff member had completed the incident reports; however, the staff member did not offer the parents/guardians a copy. The staff member’s employment was terminated 9/11/24. During today’s visit, I monitored the facility’s incident log and incident reports from the classroom of one-year-olds. All incidents were logged. Incident reports were on-file for all logged incidents. Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parents/guardians, nor offered to the parents/guardians. Based on today’s interview and monitoring of incident reports, the concern of records not being completed as required is substantiated. Ms. Pace stated that there had been concerns about the same staff member’s interactions with parents/guardians which were not of a nurturing and caring nature. Ms. Pace stated that the staff member interacted with the children in a nurturing and caring manner and no concerns were brought to her attention of non-nurturing or caring interactions with the children. Based on today’s interview and the information received, there is insufficient evidence to support the nurture and care concern. Therefore, the concern of nurture and care is unsubstantiated. Ms. Pace stated that she was not aware of any concerns with the pick-up or drop-off of children. All staff have color copies of the identifications of persons on the children’s pick-up list. The parents/guardians enter the classrooms via a code mechanism. Ms. Pace stated that the parents/guardians of the one-year-old children are all well known to the staff. I suggested reviewing the drop-off and pick-up procedures, using the picture IDs, with staff on a regular basis, as a refresher, to ensure the children are released only to the persons identified on the pick-up list. During today’s visit, I monitored the facility’s drop-off and pick-up procedures in the family handbook. Based on the procedures I monitored, and the picture ID’s I observed, there is insufficient evidence to support the concern of safe pick-up and drop-off procedures. Therefore, the concern of safe pick-up and drop-off procedures is unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 303 Children were not adequately supervised at all times. It was confirmed that a staff member was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. .1801(a)(1-5) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parent/guardian. .0802 (e) Technical assistance provided as follows: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS #303- It was confirmed that a staff member was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. You stated that the staff member that was not adequately supervising the one-year-old children had their employment terminated 9/11/24. You stated that all staff are required to adequately supervise the children. You have modeled supervision and given guidance for supervision strategies. We discussed that a substantiated concern and violation of supervision may lead to an Administrative Action. 10A NCAC 09 .1721 REQUIREMENTS FOR RECORDS #852-Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parent/guardian. You stated that the staff are trained on the incident report procedures upon hire. You stated that the staff member not completing the incident reports as required had their employment terminated 9/11/24. Achieving Compliance: A follow-up visit will be conducted to verify compliance of violation #303 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 10/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0924-200L Visit Date: 9/23/2024 Number Present: 31 Completed Date: 9/23/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 11:00 AM Time Out: 02:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by The Division of Child Development and Early Education (DCDEE) on 9/13/24 and by Dawn McCrary, Child Care Consultant, 9/13/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Dawn McCrary, Child Care Consultant and also signed by Tracy Pace, Director, during the visit. A signed copy of the visit summary was left on-site for you. Upon my arrival, I made my presence known to Tracy Pace, Director, and explained the reason for my visit. There are concerns regarding supervision, nurture and care. There are concerns regarding safe pick up and drop off procedures were not followed and records. Ms. Pace stated that she was aware of a staff member that was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. Ms. Pace stated that she had modeled and discussed proper supervision with the staff member in question. Ms. Pace stated that the staff member was not receptive to her supervision guidance. Ms. Pace terminated the staff member’s employment 9/11/24. During today’s visit, I monitored the classroom of one-year-olds. Supervision was adequate. I suggested installing a mirror above the diaper changing table to assist with supervising children while changing diapers. Based on Ms. Pace’s confirmation of inadequate supervision, the concern regarding supervision is substantiated. Ms. Pace stated that it was brought to her attention that the same staff member was not offering incident reports to parents/guardians at pick up. Ms. Pace had trained the staff member on the proper completion of incident reports. The staff member had completed the incident reports; however, the staff member did not offer the parents/guardians a copy. The staff member’s employment was terminated 9/11/24. During today’s visit, I monitored the facility’s incident log and incident reports from the classroom of one-year-olds. All incidents were logged. Incident reports were on-file for all logged incidents. Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parents/guardians, nor offered to the parents/guardians. Based on today’s interview and monitoring of incident reports, the concern of records not being completed as required is substantiated. Ms. Pace stated that there had been concerns about the same staff member’s interactions with parents/guardians which were not of a nurturing and caring nature. Ms. Pace stated that the staff member interacted with the children in a nurturing and caring manner and no concerns were brought to her attention of non-nurturing or caring interactions with the children. Based on today’s interview and the information received, there is insufficient evidence to support the nurture and care concern. Therefore, the concern of nurture and care is unsubstantiated. Ms. Pace stated that she was not aware of any concerns with the pick-up or drop-off of children. All staff have color copies of the identifications of persons on the children’s pick-up list. The parents/guardians enter the classrooms via a code mechanism. Ms. Pace stated that the parents/guardians of the one-year-old children are all well known to the staff. I suggested reviewing the drop-off and pick-up procedures, using the picture IDs, with staff on a regular basis, as a refresher, to ensure the children are released only to the persons identified on the pick-up list. During today’s visit, I monitored the facility’s drop-off and pick-up procedures in the family handbook. Based on the procedures I monitored, and the picture ID’s I observed, there is insufficient evidence to support the concern of safe pick-up and drop-off procedures. Therefore, the concern of safe pick-up and drop-off procedures is unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 303 Children were not adequately supervised at all times. It was confirmed that a staff member was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. .1801(a)(1-5) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parent/guardian. .0802 (e) Technical assistance provided as follows: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS #303- It was confirmed that a staff member was not adequately supervising the one-year-old children which led to children being bitten repeatedly and receiving other scrapes and bruises. You stated that the staff member that was not adequately supervising the one-year-old children had their employment terminated 9/11/24. You stated that all staff are required to adequately supervise the children. You have modeled supervision and given guidance for supervision strategies. We discussed that a substantiated concern and violation of supervision may lead to an Administrative Action. 10A NCAC 09 .1721 REQUIREMENTS FOR RECORDS #852-Two incident reports dated 9/6/24 and 9/11/24 were not signed by the parent/guardian. You stated that the staff are trained on the incident report procedures upon hire. You stated that the staff member not completing the incident reports as required had their employment terminated 9/11/24. Achieving Compliance: A follow-up visit will be conducted to verify compliance of violation #303 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 10/7/24. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at dawn.mccrary@dhhs.nc.gov or 828.556.3088, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0424-469L Visit Date: 5/7/2024 Number Present: 40 Completed Date: 5/7/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:00 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by DCDEE 4/30/24 and by Dawn McCrary, Child Care Consultant 5/1/24. Upon arrival, I made my presence known to Tracy Pace, Administrator, and explained the reason for today’s visit. Ms. Pace was available to assist during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Tracy Pace, Administrator, during the visit. The report was printed and a signed copy of the visit summary was left on site for you. Permit type – Five Star Child Care License issued 4/30/24 earning six (6) points in Staff Education; six (6) points in Program Standards; and one (1) Quality Point. Permit restrictions: Daytime care only; Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. There are concerns regarding staff/child ratio. According to the reporter, in the classroom occupied by two-year-olds, the ratio is 1 staff to 13 children daily. A walk-through of the facility was conducted during today’s visit to monitor staff/child ratios. The classrooms of two-year olds’ attendance, sign-in/sign-out documentations, as well as staff’s hours of attendance in the classrooms from the past two weeks were monitored during today’s visit. The requirements for enhanced ratios are as follows: Age Ratio Staff/Children Maximum Group Size 0-12 months 1/5 10 1 to 2 years 1/6 12 2 to 3 years 1/9 18 3 to 4 years 1/10 20 4 to 5 years 1/13 25 5 to 6 years 1/15 25 6 years and older 1/20 25 In space C there was one (1) staff and seven (7) two-year-old children present. In space B there was one (1) staff and six (6) two-year-old children present. In space A there was one (1) staff and one (1) infant present. In space D there was one (1) staff and six (6) one-year-old children present. In space 3 there was one (1) staff and twelve (12) four-year-old children present. In space 4 there was one (1) staff and eight (8) three-year-old children present. Classroom A operates 8:00am to 5:30pm and is covered by one staff member from 8:00am to 11:00am. The lead teacher covers from 11:00am to 5:00pm. There are two (2) infants enrolled. Classroom B operates 7:30am-5:30 pm and is covered by the lead teacher from 8:30am-5:30pm. There are nine (9) two-year-olds enrolled. Classroom C operates 7:30am-5:30 pm and is covered by the lead teacher from 8:30am-4:30pm. There are seven (7) two-year-old children enrolled. Classroom D operates 8:00am-5:00pm and is covered by the lead teacher from 8:00am to 5:00pm. There are six (6) one-year-old children enrolled. Classroom 3 operates 7:30am-5:30pm and is covered by the lead teacher from 7:30am to 3:30 pm and a floater from 3:30pm to 5:30pm. There are thirteen (13) four-year-old children enrolled. Classroom 4 operates 7:30am-5:30pm and is covered by the lead teacher from 7:30am-5:30pm. There are ten (10) three-year-old children enrolled. Ms. Pace stated that the children are combined for the first and last hour of the day. There are two (2) floaters and one (1) administrator available for breaks and additional coverage when needed. The ratio for the youngest child is met during the time the children are combined. Based on today’s observations, monitoring and interviews the complaint of staff/child ratio is unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ . The following violations were documented during today's visit Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space B, on 4/23/24, departure times for two (2) children were not documented. On 4/24/24, departure times for four (4) children were not documented. On 5/2/24, departure time for one (1) child was not documented. In space C, on 4/23/24, no departure times for the six (6) children present was documented. On 4/26/24, arrival times for three (3) children were not documented. On 5/1/24, arrival times for two (2) children were not documented. 10A NCAC 09 .0302(d)(4) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. In space D, a staff child ratio form was not posted. .0713(a)(10), (c) & (f)(3); .2818(e) 125- Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart. In space B, on 4/23/24, departure times for two (2) children were not documented. On 4/24/24, departure times for four (4) children were not documented. On 5/2/24, departure time for one (1) child was not documented. In space C, on 4/23/24, no departure times for the six (6) children present was documented. On 4/26/24, arrival times for three (3) children were not documented. On 5/1/24, arrival times for two (2) children were not documented. Plan to train staff to enter arrival and departure times of each child as they enter and depart the classrooms each day. When combining children, the children must be signed in and out on the attendance sheet of the classroom they are entering and departing for accurate record keeping. 319- Staff/child ratios applicable to a classroom, were not posted in each classroom. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (10) the staff/child ratio applicable to a classroom as described in this Paragraph shall be posted in that classroom in an area that parents are able to view at all times. In space D, a staff child ratio form was not posted. This was corrected during the visit. Plan to do a weekly monitoring of each classroom for required postings. 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 5/21/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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. Consultation is provided as follows: 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. 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: ratio. Open / not marked corrected.

10A NCAC 09 .0713 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0424-469L Visit Date: 5/7/2024 Number Present: 40 Completed Date: 5/7/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:00 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by DCDEE 4/30/24 and by Dawn McCrary, Child Care Consultant 5/1/24. Upon arrival, I made my presence known to Tracy Pace, Administrator, and explained the reason for today’s visit. Ms. Pace was available to assist during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Tracy Pace, Administrator, during the visit. The report was printed and a signed copy of the visit summary was left on site for you. Permit type – Five Star Child Care License issued 4/30/24 earning six (6) points in Staff Education; six (6) points in Program Standards; and one (1) Quality Point. Permit restrictions: Daytime care only; Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. There are concerns regarding staff/child ratio. According to the reporter, in the classroom occupied by two-year-olds, the ratio is 1 staff to 13 children daily. A walk-through of the facility was conducted during today’s visit to monitor staff/child ratios. The classrooms of two-year olds’ attendance, sign-in/sign-out documentations, as well as staff’s hours of attendance in the classrooms from the past two weeks were monitored during today’s visit. The requirements for enhanced ratios are as follows: Age Ratio Staff/Children Maximum Group Size 0-12 months 1/5 10 1 to 2 years 1/6 12 2 to 3 years 1/9 18 3 to 4 years 1/10 20 4 to 5 years 1/13 25 5 to 6 years 1/15 25 6 years and older 1/20 25 In space C there was one (1) staff and seven (7) two-year-old children present. In space B there was one (1) staff and six (6) two-year-old children present. In space A there was one (1) staff and one (1) infant present. In space D there was one (1) staff and six (6) one-year-old children present. In space 3 there was one (1) staff and twelve (12) four-year-old children present. In space 4 there was one (1) staff and eight (8) three-year-old children present. Classroom A operates 8:00am to 5:30pm and is covered by one staff member from 8:00am to 11:00am. The lead teacher covers from 11:00am to 5:00pm. There are two (2) infants enrolled. Classroom B operates 7:30am-5:30 pm and is covered by the lead teacher from 8:30am-5:30pm. There are nine (9) two-year-olds enrolled. Classroom C operates 7:30am-5:30 pm and is covered by the lead teacher from 8:30am-4:30pm. There are seven (7) two-year-old children enrolled. Classroom D operates 8:00am-5:00pm and is covered by the lead teacher from 8:00am to 5:00pm. There are six (6) one-year-old children enrolled. Classroom 3 operates 7:30am-5:30pm and is covered by the lead teacher from 7:30am to 3:30 pm and a floater from 3:30pm to 5:30pm. There are thirteen (13) four-year-old children enrolled. Classroom 4 operates 7:30am-5:30pm and is covered by the lead teacher from 7:30am-5:30pm. There are ten (10) three-year-old children enrolled. Ms. Pace stated that the children are combined for the first and last hour of the day. There are two (2) floaters and one (1) administrator available for breaks and additional coverage when needed. The ratio for the youngest child is met during the time the children are combined. Based on today’s observations, monitoring and interviews the complaint of staff/child ratio is unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ . The following violations were documented during today's visit Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space B, on 4/23/24, departure times for two (2) children were not documented. On 4/24/24, departure times for four (4) children were not documented. On 5/2/24, departure time for one (1) child was not documented. In space C, on 4/23/24, no departure times for the six (6) children present was documented. On 4/26/24, arrival times for three (3) children were not documented. On 5/1/24, arrival times for two (2) children were not documented. 10A NCAC 09 .0302(d)(4) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. In space D, a staff child ratio form was not posted. .0713(a)(10), (c) & (f)(3); .2818(e) 125- Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart. In space B, on 4/23/24, departure times for two (2) children were not documented. On 4/24/24, departure times for four (4) children were not documented. On 5/2/24, departure time for one (1) child was not documented. In space C, on 4/23/24, no departure times for the six (6) children present was documented. On 4/26/24, arrival times for three (3) children were not documented. On 5/1/24, arrival times for two (2) children were not documented. Plan to train staff to enter arrival and departure times of each child as they enter and depart the classrooms each day. When combining children, the children must be signed in and out on the attendance sheet of the classroom they are entering and departing for accurate record keeping. 319- Staff/child ratios applicable to a classroom, were not posted in each classroom. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (10) the staff/child ratio applicable to a classroom as described in this Paragraph shall be posted in that classroom in an area that parents are able to view at all times. In space D, a staff child ratio form was not posted. This was corrected during the visit. Plan to do a weekly monitoring of each classroom for required postings. 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 5/21/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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. Consultation is provided as follows: 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. 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: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: DAWN MCCRARY Operation Type: Center Case Number: 0424-469L Visit Date: 5/7/2024 Number Present: 40 Completed Date: 5/7/2024 Age: From 0 To 4 Total Minutes: 180 Time In: 09:00 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to investigate a complaint received by DCDEE 4/30/24 and by Dawn McCrary, Child Care Consultant 5/1/24. Upon arrival, I made my presence known to Tracy Pace, Administrator, and explained the reason for today’s visit. Ms. Pace was available to assist during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Dawn McCrary, Child Care Consultant and also signed by Tracy Pace, Administrator, during the visit. The report was printed and a signed copy of the visit summary was left on site for you. Permit type – Five Star Child Care License issued 4/30/24 earning six (6) points in Staff Education; six (6) points in Program Standards; and one (1) Quality Point. Permit restrictions: Daytime care only; Maximum of twelve staff due to septic system restriction; Meets enhanced ratios; Meets enhanced space. There are concerns regarding staff/child ratio. According to the reporter, in the classroom occupied by two-year-olds, the ratio is 1 staff to 13 children daily. A walk-through of the facility was conducted during today’s visit to monitor staff/child ratios. The classrooms of two-year olds’ attendance, sign-in/sign-out documentations, as well as staff’s hours of attendance in the classrooms from the past two weeks were monitored during today’s visit. The requirements for enhanced ratios are as follows: Age Ratio Staff/Children Maximum Group Size 0-12 months 1/5 10 1 to 2 years 1/6 12 2 to 3 years 1/9 18 3 to 4 years 1/10 20 4 to 5 years 1/13 25 5 to 6 years 1/15 25 6 years and older 1/20 25 In space C there was one (1) staff and seven (7) two-year-old children present. In space B there was one (1) staff and six (6) two-year-old children present. In space A there was one (1) staff and one (1) infant present. In space D there was one (1) staff and six (6) one-year-old children present. In space 3 there was one (1) staff and twelve (12) four-year-old children present. In space 4 there was one (1) staff and eight (8) three-year-old children present. Classroom A operates 8:00am to 5:30pm and is covered by one staff member from 8:00am to 11:00am. The lead teacher covers from 11:00am to 5:00pm. There are two (2) infants enrolled. Classroom B operates 7:30am-5:30 pm and is covered by the lead teacher from 8:30am-5:30pm. There are nine (9) two-year-olds enrolled. Classroom C operates 7:30am-5:30 pm and is covered by the lead teacher from 8:30am-4:30pm. There are seven (7) two-year-old children enrolled. Classroom D operates 8:00am-5:00pm and is covered by the lead teacher from 8:00am to 5:00pm. There are six (6) one-year-old children enrolled. Classroom 3 operates 7:30am-5:30pm and is covered by the lead teacher from 7:30am to 3:30 pm and a floater from 3:30pm to 5:30pm. There are thirteen (13) four-year-old children enrolled. Classroom 4 operates 7:30am-5:30pm and is covered by the lead teacher from 7:30am-5:30pm. There are ten (10) three-year-old children enrolled. Ms. Pace stated that the children are combined for the first and last hour of the day. There are two (2) floaters and one (1) administrator available for breaks and additional coverage when needed. The ratio for the youngest child is met during the time the children are combined. Based on today’s observations, monitoring and interviews the complaint of staff/child ratio is unsubstantiated. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ . The following violations were documented during today's visit Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. In space B, on 4/23/24, departure times for two (2) children were not documented. On 4/24/24, departure times for four (4) children were not documented. On 5/2/24, departure time for one (1) child was not documented. In space C, on 4/23/24, no departure times for the six (6) children present was documented. On 4/26/24, arrival times for three (3) children were not documented. On 5/1/24, arrival times for two (2) children were not documented. 10A NCAC 09 .0302(d)(4) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. In space D, a staff child ratio form was not posted. .0713(a)(10), (c) & (f)(3); .2818(e) 125- Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (4) daily records of arrival and departure times at the center for each child which shall be maintained as children arrive and depart. In space B, on 4/23/24, departure times for two (2) children were not documented. On 4/24/24, departure times for four (4) children were not documented. On 5/2/24, departure time for one (1) child was not documented. In space C, on 4/23/24, no departure times for the six (6) children present was documented. On 4/26/24, arrival times for three (3) children were not documented. On 5/1/24, arrival times for two (2) children were not documented. Plan to train staff to enter arrival and departure times of each child as they enter and depart the classrooms each day. When combining children, the children must be signed in and out on the attendance sheet of the classroom they are entering and departing for accurate record keeping. 319- Staff/child ratios applicable to a classroom, were not posted in each classroom. 10A NCAC 09 .0713 STAFF/CHILD RATIOS FOR CENTERS (10) the staff/child ratio applicable to a classroom as described in this Paragraph shall be posted in that classroom in an area that parents are able to view at all times. In space D, a staff child ratio form was not posted. This was corrected during the visit. Plan to do a weekly monitoring of each classroom for required postings. 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 5/21/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: dawn.mccrary@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Dawn McCrary PO Box 397 Penrose, NC 28766 Please call me at 828-556-3088, or email dawn.mccrary@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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. Consultation is provided as follows: 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. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0102 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .0304 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .0510 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .0606 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .0903 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .2215 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .2802 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .2809 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .2818 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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. 110-91 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 3/27/2024 Number Present: 37 Completed Date: 3/27/2024 Age: From 0 To 5 Total Minutes: 335 Time In: 09:55 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the third temporary time period visit at this program was to conduct limited monitoring of child care requirements and review the Environment Rating Scale assessment scores for the prep year. Tracy Pace, Administrator, was on-site and available to answer and ask questions. The visit summary was reviewed with you, printed, signed, and a copy left with you. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 3/11/24. The last lockdown drill was practiced on or 3/18/24. The last playground inspection was completed on 1/2/24. The last sanitation inspection was completed on 3/18/24 with eleven (11) demerits for a Superior rating. The water lead testing stated "in process" on the sanitation inspection. Verification of the water lead test being in process is required during the temporary time period. An approved fire inspection was completed 1/4/24. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies meet all required topics. The Emergency Preparedness Response (EPR) plan was completed today, 3/27/24. Plan to review the updated EPR plan with staff at the next staff meeting in April 2024. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group activities, and outdoor play. All children bring meals and snacks and have a nutrition opt-out form on file. There was one new staff, an uncompensated provider. The file was reviewed. Ms. Pace would like to take the option to transition to a star-rated license based on the previous ownership’s star-rated license points. Based on the change of ownership, the facility would be included in Cohort 1. We discussed the resources available during the 2024-25 assessment year. Plan to visit the North Carolina Rated License Assessment Project (NCRLAP) website, ncrlap.org, for additional information, webinars, and resources. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 512 Meals and snacks for all children were not planned according to the number of hours the child is in care. Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. 0.0903 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. 15A NCAC 18A .2820(d) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. .0803(12) 871 Center staff did not comply with the safe sleep policy. The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance on 3/22/24, 3/25/24, and 3/26/24. 10A NCAC 09 .0606(a) Technical assistance for correction plan: Item #512 – Per Ms. Pace, children in spaces # 3, 4, B are not served breakfast or a morning snack. The operating hours for the center are from 7:30am through 5:30pm and parents only bring in lunch and an afternoon snack in the aforementioned spaces. Since all children have a nutrition opt-out form on file and if a parent does not bring a meal or snack, the center shall replace the missing meal or snack. Notify parents that they will need to bring in breakfast or a morning snack for their child in addition to lunch and an afternoon snack. Plan to be prepared to supplement a morning snack or breakfast. We discussed as of 4/1/24 the center will begin providing all meals and snacks. 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (d) A child's parent may opt out of the supplemental food provided by the center as set forth in G.S. 110-91(2)h.1. When a child's parent opts out of the supplemental food provided by the center, the parent shall sign a statement acknowledging the parental decision shall be kept in the child's file at the center and a copy provided to the parent. A child's parent may opt out of the supplemental food provided by the center, subject to the following: (1) the center shall not provide any food or drink so long as the child's parent or guardian provides all meals, snacks, and drinks scheduled to be served at the center's designated times; (2) the ability to opt out of specific meals or days based on menu options is not available; (3) if a child requests specific foods being served to other children, but the parent has opted out, the center shall not serve supplemental food; and (4) if the child's parent or guardian has opted out, but does not provide all meals and snacks for the child, the center shall replace the missing meal or snack as if the child's parent or guardian had not opted out of the supplemental food program. 10A NCAC 09 .0903 REQUIREMENTS FOR CHILDREN AGED 15 MONTHS AND OLDER Meals and snacks shall be planned according to the number of hours a child is in the center. Children shall be provided a meal or snack a minimum of every four hours. These rules apply in all situations except during sleeping hours and nighttime care: Hours Child Is In Care - At least 6 hours but less than 12 hours Age of Child - All Children Snack and Meal Requirement - 2 meals and 1 snack OR 2 snacks and 1 meal equal to ½ of the child's daily food needs Item #871 – The caregiver in space #A, the classroom with infants, has not documented visual checks for an eleven month old enrolled infant since 3/20/24 when the child was in attendance. We discussed that even though a child transitions from a crib a cot, the safe sleep policy must still be followed and children ages 12 months and younger must be visually checked at least every 15 minutes. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (a) Each center licensed to care for infants aged 12 months or younger shall develop, adopt, and comply with a written safe sleep policy that: (6) specifies that caregivers shall visually check, in person, sleeping infants aged 12 months or younger at least every 15 minutes; (7) specifies how caregivers shall document compliance with visually checking on sleeping infants aged 12 months or younger; Corrected during the visit. Item #849 – In space #A, the classroom with infants, there were three (3) diaper creams stored in the classroom for children that were no longer enrolled. This was corrected during the visit by removing the diaper creams from the classroom and discarding them in the trash in the front office. Ms. Pace locked the front office when no one was in there. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. Corrected during the visit. Item #841 – In space #A, the classroom with infants, there was Nystatin prescription diaper cream stored above five feet and not locked. This was corrected during the visit by removing the Nystatin from the classroom and discarding it in the trash in the front office since the child is no longer enrolled. Ms. Pace locked the front office when no one was in there. 15A NCAC 18A .2820 STORAGE (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 4/10/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 85%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied for a position for evaluation. This is recommended to be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Pre-service requirements must be met for all positions. The facility will use the six (6) points for staff education based on the previous ownership. Program Standards: The average score for the ECERS-R conducted on 3/6/2024 is 4.44 points. The average score for the ITERS-R conducted on 3/12/2024 is 5.77 points. According to the program requirements for the NC Star Rated License: The overall average score (across 2 assessments) is 5.11 points. The average classroom score is 5 or higher with no one classroom score lower than 4.0. For official assessments and reassessments this information will be used by the DCDEE to determine the number of points your program will earn in the Program Standards component of your star rated license. For cohort model programs during the Preparation Year, it is your choice whether the scores will apply to your license or if program planning and enhancement followed by another assessment with official scores is preferred. The facility will use the six (6) points for program standards based on the previous ownership. The facility will be included in Cohort 1 to resume the next rated license cycle. We discussed resources available during the visit today. The facility is required to meet enhanced space and enhanced staff/child ratios. 10A NCAC 09 .2809 ENHANCED SPACE REQUIREMENTS (a) There shall be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. (b) There shall be an area that can be arranged for administrative and private conference activities. 10A NCAC 09 .2818 ENHANCED STAFF/CHILD RATIOS FOR A RATED LICENSE FOR CHILD CARE CENTERS (a) This Rule shall apply to evaluating the staff/child ratios and maximum group sizes for a rated license for child care centers. (b) The center shall comply with the following staff/child ratios and maximum group sizes. Age Ratio Staff/Children Maximum Group Size 0 to 12 Months 1/5 10 1 to 2 Years 1/6 12 2 to 3 Years 1/9 18 3 to 4 Years 1/10 20 4 to 5 Years 1/13 25 5 to 6 Years 1/15 25 6 Years and Older 1/20 25 Quality Point: The facility will use the one (1) quality point based on the previous ownership. Curriculum: The approved curriculum being implemented by the facility is Creative Curriculum, 6th Edition. 10A NCAC 09 .2802 APPLICATION FOR A TWO THROUGH FIVE STAR RATED LICENSE (d) Facilities with a four or five-star rated license that are licensed to serve four-year-old children shall implement a curriculum as defined in 10A NCAC 09 .0102(10) with their four year olds. The centers rated license assessment is due once every three years based on the date of the completed Environment Rating Scale scores, if applicable. During the three-year reassessment, the center’s program standards, staff education and a quality point option are determined to award the center’s star level. It is the center operator’s responsibility to maintain the same point level under each component at all times. If changes occur that may affect your rated license, please notify your licensing consultant to inform her of the changes and discuss a plan of action to maintain the center’s star rating. 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. 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. Rated License Consultation and Review of Environment Rating Scale assessment report: ECERS-R Summary Report Scores Under Three (3) Points Item #10 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The teacher reported that meals and snacks are brought from home. According to the daily schedule and confirmed by teacher report, the children are provided with a time to eat a lunch and snack in the afternoon. Although the schedule indicates a time for children to eat breakfast, the teacher reported that at this time the children are not served breakfast and the children are encouraged to eat breakfast at home. An additional meal or snack is not provided, which does not meet the indicator's requirements for a program that operates 10 hours (7:30 a.m. - 5:30 p.m.).” Item #11 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot, and 6 out of 9 blankest touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. We discussed not to fold blankets so that they would not touch another cot. Item #12 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Two pull-up routines occurred as the children toileted. In addition, two diaper/pull up changes occurred on the diapering table. Preparations: Preparations were made before 1 of the 4 routines. Disposal: One soiled pull up was disposed of properly. During the other routines the soiled pull ups/diaper remined on the floor or diaper surface and were disposed of at the end of the routines. Wipes: For the children that toileted independently; assistance from the teachers was not needed. During the other two diaper/pull up routines, neither the teacher nor children used a wipe to clean their hands after removal of the soiled diaper/pull up, before redressing the children. Clean/Disinfect: Following each diaper routine the surface was cleaned and disinfected appropriately. For more information on procedures required during diapering/pull-up routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. In addition, children and the teacher used the sink beside the toilet to wash their hands after toileting/diaper/pull up routines, upon arrival, after touching the trash can, and before/after lunch. The sink was not sprayed with a disinfectant after toileting/diaper/pull up routines before it was used for other purposes.” This is a potential sanitation violation. The sanitation rules for diaper changing must be followed. We discussed to review the diaper changing requirements with teachers. Item #13 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “This indicator requires that teachers and children wash their hands at least 75% of the time when needed upon arrival/reentry, before and after water play and after messy play, after contact with bodily fluids, and after touching contaminated objects. The children washed their hands as needed. The teacher washed her hands 50% of the time. She did not wash her hands after removing a mouthed toy.” This is a potential sanitation violation. The sanitation rules must be followed for handwashing. We discussed to review the required handwashing times with teachers. Item #14 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Indoors, there were instances when the changing table was sprayed with a disinfectant and the table was sprayed with a sanitizer, as children stood close by. The mist from the solutions is a potential eye/lung irritant for children.” This is a potential sanitation violation. The sanitation rules must be followed for use of chemicals according to the manufacturer instructions. We discussed to review the use of chemicals with teachers. 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. Item #20 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “There were no art materials out for children to use in their classroom. The teacher reported that if children want to use art materials, she will get them down if they ask for them. Since the children are not able to use art materials for 1 hour each day, this indicator did not earn credit.” This is a potential licensing violation. Per staff reports today, art materials are offered daily. We discussed the child care facility is meeting minimum licensing requirements by having children’s books, blocks and block building, manipulatives, and dramatic play daily, which allows for art to be available at least monthly. § 110-91. Mandatory standards for a license. (12) Developmentally Appropriate Activities. – Each facility shall have developmentally appropriate activities and play materials. The Commission shall establish minimum standards for developmentally appropriate activities for child care facilities. Each child care facility shall have a planned schedule of developmentally appropriate activities displayed in a prominent place for parents to review and the appropriate materials and equipment available to implement the scheduled activities. Each child care center shall make four of the following activity areas available daily: art and other creative play, children's books, blocks and block building, manipulatives, and family living and dramatic play. 10A NCAC 09 .0510 ACTIVITY AREAS (a) For each group of children in care, the center shall provide daily four of the five activity areas listed in G.S. 110-91(12) as follows: (1) Centers with a licensed capacity of 30 or more children shall have at least four activity areas available in the space occupied by a group of children. (b) In addition to the four activity areas that are available each day, each center shall have materials and equipment in sufficient quantity, as described in Subparagraph (d)(1) of this Rule, to ensure that the fifth activity area listed in G.S. 110-91(12) is made available at least once per month. Item #26 scored one (1) point. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “The classroom's math materials included: Counting: counting book, caterpillar with numbers and dots Measuring: height chart Comparing quantities: no examples Shapes: magnetic tiles Written number: cash register, phone, clock, numbers on the kitchen set, a truck, and in the display To earn credit for this indicator there should be at least two materials from three of the categories listed above; this requirement was met in two categories (counting and written numbers). Since there were no examples for comparing quantities, an additional material was needed in shapes and/or measuring category.” While this is not a licensing requirement, it is best practice for a higher quality environment. ITERS-R Summary Report Scores Under Three (3) Points Item #7 scored two (2) points. Indicator 3.4 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “While the teacher interacted with the group of children on the carpet in the block area, and the other teacher was by the sink, a child ate his breakfast at the table. While children ate their lunch, a teacher changed a child's diaper and the other teacher walked back and forth from the table to the shelf where the lunches were stored. Additionally, during this time a teacher placed out cots and the other teacher left the meal table to get a fork for a child. Because teachers focused on other activities while the children ate, credit could not be earned.” This is a potential licensing violation. When children are eating, supervision rules require that staff must be able to see and hear children during meals and snacks. There was no indication that staff could not hear and see the children during meal times. 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request. Item #8 scored two (2) points. Indicator 3.2 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “When stored, the cots were stacked on top of one another. A blanket was folded and placed in the middle of each cot. Five of the 7 blankets touched the bottom of the cot stacked above. The cots were made out of a permeable material, allowing for the potential transfer of germs between the children's bedding and the cots.” This is a potential sanitation violation. Review the sanitation requirements for storage of cots. Item #9 scored two (2) points. Indicator 3.1 was not met. Observation notes from the North Carolina Rated License Assessment Project (NCRLAP): “Six diaper/pull up routines were observed: Preparations: For all routines, diapers/pull ups and wipes were removed from the cubbies before the children were placed on the diaper surface. Disposal: The diapers/pull ups were disposed of properly each time. Wipes: The use of diaper wipes to clean the teacher's and child's hands occurred for one routine. For the other five routines, wipes were not used on the child's or teacher's hands between removing the soiled diaper/pull up, before handling the clean diaper/pull up. Clean/Disinfect: This indicator required that the diaper surface is sprayed with soapy water, wiped with a paper towel, and sprayed with a disinfectant solution that is allowed to air dry for at least 2 minutes. Following the first two routines, the surface was cleaned with soapy water and then sprayed with a disinfectant that was wipe dry after 1 minute. Following the third routine the surface was sprayed with a disinfectant, wiped dry immediately and then sprayed with a disinfectant again that was allowed to air dry for at least 2 minutes. For the fourth and fifth routines, the surface was sprayed with a sanitizer, rather than a disinfectant and soapy water was not first used to clean the surface. For the sixth routine the surface was not cleaned or disinfected. For more information on procedures required during diapering routines, please refer to the diapering procedure poster from the North Carolina Child Care Health and Safety Resource Center. Additionally, the teachers and children used the sink near the diaper changing table/toilet to wash their hands following toileting and diaper/pull up changes, after outdoor play, following nose wipes, after using markers, as well as before and after meals. Although the sink was sprayed with a disinfectant after one pull up routine, it was not consistently disinfected after teachers and children washed their hands after diaper/pull up/toilet routines before it was used for another purpose. Indicator 3.3 The children's hands were washed consistently after diaper/pull up changes, and toileting; however, the teachers washed their hands 33% of the times needed, which was less than the required 75%. Of the 6 diaper/pull up changes that occurred, the teachers washed their hands 2 times after spraying disinfectant on the diapering surface. During the other occasions, the teachers touched children or washed their hands before cleaning the changing table. This is a potential sanitation violation. We discussed to review diaper changing procedures and handwashing procedures with teachers. Consultation: If a zoning letter and building inspection are not completed during the temporary time period, it may result in a denial of a license. In addition, the lead water testing process must be in process during the temporary time period or it may result in a denial of a license. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator's non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; We discussed the annual fire inspection is due on or before 1/4/25. You will need to contact the local Fire Marshal for the annual inspection. The original approved inspection must be mailed to the child care consultant within one week. Reminder that the Fire Marshal must also monitor the auxiliary spaces. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (a) Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. We discussed that correct hand washing and diapering posters must be posted to allow for staff to follow the correct procedures and to know when to wash hands, both for children and employees. 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. (b) The use of a hand antiseptic does not replace the requirements for handwashing in Paragraph (a) of this Rule except that an employee who is supervising a child or children outdoors may use a hand antiseptic while outdoors in lieu of handwashing, provided that the employee's hands are washed in accordance with Paragraph (e) of this Rule when the employee returns indoors. Hand antiseptic shall not be used in lieu of handwashing when the employee's action that necessitates handwashing is diapering, food preparation, or food service. (c) Child care center employees shall ensure that children wash their hands as follows: (1) upon arrival at the child care center; (2) after each diaper change or visit to the toilet; (3) before eating meals or snacks; (4) before and after water play; (5) after being outdoors; and (6) after handling animals or animal cages. (d) Except when the action that necessitates handwashing is diapering and before eating meals or snacks, hand antiseptics may be used in lieu of handwashing while a child is outdoors, provided that the child's hands are washed when the child returns indoors. (e) Handwashing procedures shall include the following steps: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails, and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying the hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2818 LAVATORIES (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section. 15A NCAC 18A .2819 DIAPERING AND DIAPER CHANGING FACILITIES (d) Child care center employees shall change a child's diaper as follows: (1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee. (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. We discussed that a thermometer is required in any refrigerator stored with food, milk, or bottles for children. During a future visit, it may be requested by the child care consultant to observe a fire drill, shelter-in-place drill, or lockdown drill. After the rated license is processed, Dawn McCrary will be assigned as your child care consultant. You may reach Ms. McCrary at dawn.mccrary@dhhs.nc.gov or 828.556.3088. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. 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 as needed. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .0510 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 40 Completed Date: 1/18/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 10:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Tracy Pace and Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 1/4/24. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/24. The last playground inspection was completed on 1/2/24. A sanitation inspection must be completed during the temporary time period. Jim Boyer, Transylvania County Environmental Health Specialist, has been contacted. An approved fire inspection was completed 1/4/24. The original fire inspection was collected during the visit today. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group outdoor play.. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There was one (1) new staff. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in Cohort 1 of the rated license cycle. The prep year assessment has been requested and was ordered today during the visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. There were no dolls in space #A, the classroom with infant and one year old children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. One (1) child, ten months of age, had an infant feeding plan in space #A that was not modified to indicate the child is drinking juice from a cup and eating table foods. 10 NCAC 09 .0902(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. The metal trashcan in space #A, had rust spots on the lid and the sides of the trashcan. .0601(c) Technical assistance for correction plan: Safe and Sturdy Equipment - Corrected During the Visit *The trashcan with rust spots was removed from the classroom and replaced with a trashcan that is free from safety hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. Infant Feeding Plan *The infant feeding plan for the ten month old must be modified to indicate the child is drinking juice from a cup and eating table foods. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers Activity Areas for Children Under Three Years of Age – Corrected During the Visit *Dolls were added to space #A during the visit. Plan to keep dolls and other developmentally appropriate toys available for use by children. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (1) each center shall have developmentally appropriate toys and activities for each child to promote the child’s emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development, including: (A) books; (B) blocks; (C) dolls; (D) pretend play materials; (E) musical toys; (F) sensory toys; and (G) fine motor toys; 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 2/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history prior to the visit today was 84%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. All staff must have their education evaluated by WORKS. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: Applying for a two through five-star rated license and have the Environment Rating Scale (ERS) assessment is voluntary. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum, 6th Edition and was reviewed today during the visit. Consultation: We discussed any products with keep out of reach of children must be stored at least five (5) feet above the floor or can be stored locked. 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. (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A cabinet in space #A was locked and had a gallon of bleach, floor cleaner, plastic bags, and other cleaning items. It is recommended to move these items to a storage area outside of the classroom. We discussed the discipline policy has specific criteria that needs to include on the signed statement (reference the child care rule below). This can be the same as what is included in the discipline policy for behavior management in the parent/family handbook. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (a) The person who conducts the enrollment conference shall provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (a) Each center shall have written policies that describe the operation of the center and the services that are available to parents and their children. The operational policies shall include at least the following information: (9) the center's discipline policy for behavior management; 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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 monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0514 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 40 Completed Date: 1/18/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 10:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Tracy Pace and Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 1/4/24. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/24. The last playground inspection was completed on 1/2/24. A sanitation inspection must be completed during the temporary time period. Jim Boyer, Transylvania County Environmental Health Specialist, has been contacted. An approved fire inspection was completed 1/4/24. The original fire inspection was collected during the visit today. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group outdoor play.. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There was one (1) new staff. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in Cohort 1 of the rated license cycle. The prep year assessment has been requested and was ordered today during the visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. There were no dolls in space #A, the classroom with infant and one year old children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. One (1) child, ten months of age, had an infant feeding plan in space #A that was not modified to indicate the child is drinking juice from a cup and eating table foods. 10 NCAC 09 .0902(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. The metal trashcan in space #A, had rust spots on the lid and the sides of the trashcan. .0601(c) Technical assistance for correction plan: Safe and Sturdy Equipment - Corrected During the Visit *The trashcan with rust spots was removed from the classroom and replaced with a trashcan that is free from safety hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. Infant Feeding Plan *The infant feeding plan for the ten month old must be modified to indicate the child is drinking juice from a cup and eating table foods. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers Activity Areas for Children Under Three Years of Age – Corrected During the Visit *Dolls were added to space #A during the visit. Plan to keep dolls and other developmentally appropriate toys available for use by children. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (1) each center shall have developmentally appropriate toys and activities for each child to promote the child’s emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development, including: (A) books; (B) blocks; (C) dolls; (D) pretend play materials; (E) musical toys; (F) sensory toys; and (G) fine motor toys; 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 2/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history prior to the visit today was 84%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. All staff must have their education evaluated by WORKS. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: Applying for a two through five-star rated license and have the Environment Rating Scale (ERS) assessment is voluntary. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum, 6th Edition and was reviewed today during the visit. Consultation: We discussed any products with keep out of reach of children must be stored at least five (5) feet above the floor or can be stored locked. 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. (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A cabinet in space #A was locked and had a gallon of bleach, floor cleaner, plastic bags, and other cleaning items. It is recommended to move these items to a storage area outside of the classroom. We discussed the discipline policy has specific criteria that needs to include on the signed statement (reference the child care rule below). This can be the same as what is included in the discipline policy for behavior management in the parent/family handbook. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (a) The person who conducts the enrollment conference shall provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (a) Each center shall have written policies that describe the operation of the center and the services that are available to parents and their children. The operational policies shall include at least the following information: (9) the center's discipline policy for behavior management; 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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 monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 40 Completed Date: 1/18/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 10:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Tracy Pace and Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 1/4/24. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/24. The last playground inspection was completed on 1/2/24. A sanitation inspection must be completed during the temporary time period. Jim Boyer, Transylvania County Environmental Health Specialist, has been contacted. An approved fire inspection was completed 1/4/24. The original fire inspection was collected during the visit today. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group outdoor play.. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There was one (1) new staff. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in Cohort 1 of the rated license cycle. The prep year assessment has been requested and was ordered today during the visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. There were no dolls in space #A, the classroom with infant and one year old children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. One (1) child, ten months of age, had an infant feeding plan in space #A that was not modified to indicate the child is drinking juice from a cup and eating table foods. 10 NCAC 09 .0902(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. The metal trashcan in space #A, had rust spots on the lid and the sides of the trashcan. .0601(c) Technical assistance for correction plan: Safe and Sturdy Equipment - Corrected During the Visit *The trashcan with rust spots was removed from the classroom and replaced with a trashcan that is free from safety hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. Infant Feeding Plan *The infant feeding plan for the ten month old must be modified to indicate the child is drinking juice from a cup and eating table foods. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers Activity Areas for Children Under Three Years of Age – Corrected During the Visit *Dolls were added to space #A during the visit. Plan to keep dolls and other developmentally appropriate toys available for use by children. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (1) each center shall have developmentally appropriate toys and activities for each child to promote the child’s emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development, including: (A) books; (B) blocks; (C) dolls; (D) pretend play materials; (E) musical toys; (F) sensory toys; and (G) fine motor toys; 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 2/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history prior to the visit today was 84%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. All staff must have their education evaluated by WORKS. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: Applying for a two through five-star rated license and have the Environment Rating Scale (ERS) assessment is voluntary. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum, 6th Edition and was reviewed today during the visit. Consultation: We discussed any products with keep out of reach of children must be stored at least five (5) feet above the floor or can be stored locked. 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. (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A cabinet in space #A was locked and had a gallon of bleach, floor cleaner, plastic bags, and other cleaning items. It is recommended to move these items to a storage area outside of the classroom. We discussed the discipline policy has specific criteria that needs to include on the signed statement (reference the child care rule below). This can be the same as what is included in the discipline policy for behavior management in the parent/family handbook. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (a) The person who conducts the enrollment conference shall provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (a) Each center shall have written policies that describe the operation of the center and the services that are available to parents and their children. The operational policies shall include at least the following information: (9) the center's discipline policy for behavior management; 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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 monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0902 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 40 Completed Date: 1/18/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 10:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Tracy Pace and Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 1/4/24. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/24. The last playground inspection was completed on 1/2/24. A sanitation inspection must be completed during the temporary time period. Jim Boyer, Transylvania County Environmental Health Specialist, has been contacted. An approved fire inspection was completed 1/4/24. The original fire inspection was collected during the visit today. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group outdoor play.. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There was one (1) new staff. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in Cohort 1 of the rated license cycle. The prep year assessment has been requested and was ordered today during the visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. There were no dolls in space #A, the classroom with infant and one year old children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. One (1) child, ten months of age, had an infant feeding plan in space #A that was not modified to indicate the child is drinking juice from a cup and eating table foods. 10 NCAC 09 .0902(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. The metal trashcan in space #A, had rust spots on the lid and the sides of the trashcan. .0601(c) Technical assistance for correction plan: Safe and Sturdy Equipment - Corrected During the Visit *The trashcan with rust spots was removed from the classroom and replaced with a trashcan that is free from safety hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. Infant Feeding Plan *The infant feeding plan for the ten month old must be modified to indicate the child is drinking juice from a cup and eating table foods. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers Activity Areas for Children Under Three Years of Age – Corrected During the Visit *Dolls were added to space #A during the visit. Plan to keep dolls and other developmentally appropriate toys available for use by children. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (1) each center shall have developmentally appropriate toys and activities for each child to promote the child’s emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development, including: (A) books; (B) blocks; (C) dolls; (D) pretend play materials; (E) musical toys; (F) sensory toys; and (G) fine motor toys; 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 2/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history prior to the visit today was 84%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. All staff must have their education evaluated by WORKS. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: Applying for a two through five-star rated license and have the Environment Rating Scale (ERS) assessment is voluntary. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum, 6th Edition and was reviewed today during the visit. Consultation: We discussed any products with keep out of reach of children must be stored at least five (5) feet above the floor or can be stored locked. 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. (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A cabinet in space #A was locked and had a gallon of bleach, floor cleaner, plastic bags, and other cleaning items. It is recommended to move these items to a storage area outside of the classroom. We discussed the discipline policy has specific criteria that needs to include on the signed statement (reference the child care rule below). This can be the same as what is included in the discipline policy for behavior management in the parent/family handbook. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (a) The person who conducts the enrollment conference shall provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (a) Each center shall have written policies that describe the operation of the center and the services that are available to parents and their children. The operational policies shall include at least the following information: (9) the center's discipline policy for behavior management; 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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 monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1804 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 40 Completed Date: 1/18/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 10:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Tracy Pace and Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 1/4/24. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/24. The last playground inspection was completed on 1/2/24. A sanitation inspection must be completed during the temporary time period. Jim Boyer, Transylvania County Environmental Health Specialist, has been contacted. An approved fire inspection was completed 1/4/24. The original fire inspection was collected during the visit today. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group outdoor play.. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There was one (1) new staff. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in Cohort 1 of the rated license cycle. The prep year assessment has been requested and was ordered today during the visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. There were no dolls in space #A, the classroom with infant and one year old children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. One (1) child, ten months of age, had an infant feeding plan in space #A that was not modified to indicate the child is drinking juice from a cup and eating table foods. 10 NCAC 09 .0902(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. The metal trashcan in space #A, had rust spots on the lid and the sides of the trashcan. .0601(c) Technical assistance for correction plan: Safe and Sturdy Equipment - Corrected During the Visit *The trashcan with rust spots was removed from the classroom and replaced with a trashcan that is free from safety hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. Infant Feeding Plan *The infant feeding plan for the ten month old must be modified to indicate the child is drinking juice from a cup and eating table foods. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers Activity Areas for Children Under Three Years of Age – Corrected During the Visit *Dolls were added to space #A during the visit. Plan to keep dolls and other developmentally appropriate toys available for use by children. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (1) each center shall have developmentally appropriate toys and activities for each child to promote the child’s emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development, including: (A) books; (B) blocks; (C) dolls; (D) pretend play materials; (E) musical toys; (F) sensory toys; and (G) fine motor toys; 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 2/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history prior to the visit today was 84%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. All staff must have their education evaluated by WORKS. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: Applying for a two through five-star rated license and have the Environment Rating Scale (ERS) assessment is voluntary. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum, 6th Edition and was reviewed today during the visit. Consultation: We discussed any products with keep out of reach of children must be stored at least five (5) feet above the floor or can be stored locked. 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. (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A cabinet in space #A was locked and had a gallon of bleach, floor cleaner, plastic bags, and other cleaning items. It is recommended to move these items to a storage area outside of the classroom. We discussed the discipline policy has specific criteria that needs to include on the signed statement (reference the child care rule below). This can be the same as what is included in the discipline policy for behavior management in the parent/family handbook. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (a) The person who conducts the enrollment conference shall provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (a) Each center shall have written policies that describe the operation of the center and the services that are available to parents and their children. The operational policies shall include at least the following information: (9) the center's discipline policy for behavior management; 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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 monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 40 Completed Date: 1/18/2024 Age: From 0 To 5 Total Minutes: 225 Time In: 10:00 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of the unannounced visit today was to monitor compliance with all applicable child care requirements during the second temporary time period visit. The facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Tracy Pace and Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. The last monthly fire drill was practiced 1/4/24. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/24. The last playground inspection was completed on 1/2/24. A sanitation inspection must be completed during the temporary time period. Jim Boyer, Transylvania County Environmental Health Specialist, has been contacted. An approved fire inspection was completed 1/4/24. The original fire inspection was collected during the visit today. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was in use. The children were observed during routine care, free play, small group outdoor play.. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There was one (1) new staff. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s four-star rating and be included in Cohort 1 of the rated license cycle. The prep year assessment has been requested and was ordered today during the visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed: Violation Number Comment Rule 445 For children under three years of age, developmentally appropriate toys and activities were not provided as outlined in Rule. There were no dolls in space #A, the classroom with infant and one year old children. .0510 (e ) (1)(A-G) 542 The written feeding plan was not modified as the child's needs changed. One (1) child, ten months of age, had an infant feeding plan in space #A that was not modified to indicate the child is drinking juice from a cup and eating table foods. 10 NCAC 09 .0902(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. The metal trashcan in space #A, had rust spots on the lid and the sides of the trashcan. .0601(c) Technical assistance for correction plan: Safe and Sturdy Equipment - Corrected During the Visit *The trashcan with rust spots was removed from the classroom and replaced with a trashcan that is free from safety hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. (c) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. (d) All equipment and furnishings not meeting the requirements of Paragraphs (b) and (c) of this Rule shall be removed from the premises immediately or made inaccessible to the children. Infant Feeding Plan *The infant feeding plan for the ten month old must be modified to indicate the child is drinking juice from a cup and eating table foods. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers Activity Areas for Children Under Three Years of Age – Corrected During the Visit *Dolls were added to space #A during the visit. Plan to keep dolls and other developmentally appropriate toys available for use by children. 10A NCAC 09 .0510 ACTIVITY AREAS (e) When children under three years old are in care the following apply: (1) each center shall have developmentally appropriate toys and activities for each child to promote the child’s emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development, including: (A) books; (B) blocks; (C) dolls; (D) pretend play materials; (E) musical toys; (F) sensory toys; and (G) fine motor toys; 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 2/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history prior to the visit today was 84%. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. All staff must have their education evaluated by WORKS. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: Applying for a two through five-star rated license and have the Environment Rating Scale (ERS) assessment is voluntary. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum, 6th Edition and was reviewed today during the visit. Consultation: We discussed any products with keep out of reach of children must be stored at least five (5) feet above the floor or can be stored locked. 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. (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A cabinet in space #A was locked and had a gallon of bleach, floor cleaner, plastic bags, and other cleaning items. It is recommended to move these items to a storage area outside of the classroom. We discussed the discipline policy has specific criteria that needs to include on the signed statement (reference the child care rule below). This can be the same as what is included in the discipline policy for behavior management in the parent/family handbook. 10A NCAC 09 .1804 DISCIPLINE POLICY FOR CHILD CARE CENTERS (a) The person who conducts the enrollment conference shall provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. (b) The child care center shall obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement shall include the following: (1) the child's name; (2) the date of enrollment; and (3) if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (a) Each center shall have written policies that describe the operation of the center and the services that are available to parents and their children. The operational policies shall include at least the following information: (9) the center's discipline policy for behavior management; 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. 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 monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/18/2023 Number Present: 35 Completed Date: 12/18/2023 Age: From 0 To 5 Total Minutes: 205 Time In: 09:20 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance for violations that were cited during a Temporary Time Period visit on 12/4/23 and provide limited monitoring of child care requirements. Tracy Pace, Administrator, was on site and available to ask and answer questions. During the Temporary Time Period visit on 12/4/23, sixteen (16) violations were cited. The children were observed during routine care, free play, small group activities, and large group activities today during the walk through. The violations documented on 12/4/23 were monitored and discussed as follows: Item #205 – This was corrected during the visit on 12/4/23. Item #714 – The gap between the building and fence on outdoor spaces #5 and #6 had a large storage chest in front of it to close the gap during the visit on 12/4/23. During observations today, additional fencing has been added to close the gap permanently. The large storage chest has now been moved away from this area. Items #721 – The plastic gate on outdoor space #4 has been removed. The metal poles on outdoor space #4 have been removed. Item #805 – A fire drill was practiced during the visit on 12/4/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating fire drills are now scheduled and placed on the centers monthly calendar. Item #853 – The incident log was reviewed today. The incident log is in use as required. Item #858 – This was corrected during the visit on 12/4/23. Item #859 – The last monthly playground inspection was completed on 12/7/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating monthly playground inspections are now scheduled and placed on the centers monthly calendar. Items #1035 – We discussed the Emergency Information form must be on file on day one of employment. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating that a review of the orientation process was conducted, and all staff files were audited to be sure all staff had the emergency information form on file. Items #1045 and #1067 – Documentation of orientation was verified today for the one (1) staff. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating a review of the orientation process was conducted, and all staff files were audited to be sure all staff had orientation documented. Item #1048 and #1049 – CPR and First Aid training for the one (1) staff was reviewed and verified to be completed on 12/11/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Item #1052 – The three (3) staff files lacking on-going training hours were reviewed today and not verified to meet on-going training hours in accordance with their education. This is a repeat violation from 12/4/23. Item #1232 – Annual staff development plans were completed for the six (6) staff on 12/6/23. Annual staff evaluations will be completed under the new ownership annually. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Item #1867 – The depth of the surfacing on playgrounds #1, #3, and #6 has not been corrected to meet six (6) inches or more. Ms. Pace emailed a request for an extension today during the visit. Per Ms. Pace, the operator had to call around locally to find what mulch was approved to use on the playgrounds. Once the information was provided by local vendors, an order for mulch was placed on 12/15/23. Staff was notified this morning that children cannot play on the climbing structures on playgrounds #1, #3, and #6 until mulch is delivered, installed, and adequate depth. An extension has been approved through 12/22/23 at the close of business for the mulch to be delivered, installed, and of adequate depth. Item #1874 – The three (3) staff were verified to have the prevention of shaken baby and abusive head trauma policy acknowledgement on file today. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Staff child/ratio was as follows today: Space #1 was not in use by children. Space #2 was not in use by children. Space #3 had one (1) teacher and eight (8) two year through three year old children. Space #4 had one (1) teacher and nine (9) four through five year old children. Space #A had one (1) teacher and four (4) infant and one year old children. Space #B had one (1) teacher and seven (7) two year old children. Space #C was not in use by children. Space #D had two (2) teachers and seven (7) one through two year old children. There following violation of child care requirements was observed: Violation Number Comment Rule 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) of three (3) staff, S.T., required to complete ten (10) training hours and has received one (1) training hour. One (1) of three (3) staff, A.H., required to compete ten (10) training hours and has received five (5) training hours. One (1) of three (3) staff, M.F., required to complete ten (10) training hours and has receive three (3) training hours. Repeat violation from 12/4/23. .1103(a) Technical assistance for correction plan: On-going Training (repeat violation from 12/4/23) The three (3) staff must complete additional training hours from an approved agency. According to the Workforce Education Status Letter, one (1) staff meets lead teacher qualifications through the Early Childhood Certification Level 8, which requires ten (10) training hours annually. If the staff has a two year degree in early childhood education, it is recommended to send in official transcripts to WORKS for evaluation. During the visit today, it was discovered that there is training taken by staff that is not be approved. A representative from the Division of Child Development and Early Education (DCDEE) researched to find out BEE Institute is not an approved training agency through DCDEE. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Required Training Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement 15 clock hours If none of the other criteria in this chart apply 20 clock hours 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 1/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 79%. The compliance history after the visit will be reviewed to determine if the facility will be able to transition to a star-rated license or be recommended for an administrative action. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator’s non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; Consultation: We discussed that when the monthly playground inspection is completed to be sure to describe the problem and provide a solution. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .2215 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/18/2023 Number Present: 35 Completed Date: 12/18/2023 Age: From 0 To 5 Total Minutes: 205 Time In: 09:20 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance for violations that were cited during a Temporary Time Period visit on 12/4/23 and provide limited monitoring of child care requirements. Tracy Pace, Administrator, was on site and available to ask and answer questions. During the Temporary Time Period visit on 12/4/23, sixteen (16) violations were cited. The children were observed during routine care, free play, small group activities, and large group activities today during the walk through. The violations documented on 12/4/23 were monitored and discussed as follows: Item #205 – This was corrected during the visit on 12/4/23. Item #714 – The gap between the building and fence on outdoor spaces #5 and #6 had a large storage chest in front of it to close the gap during the visit on 12/4/23. During observations today, additional fencing has been added to close the gap permanently. The large storage chest has now been moved away from this area. Items #721 – The plastic gate on outdoor space #4 has been removed. The metal poles on outdoor space #4 have been removed. Item #805 – A fire drill was practiced during the visit on 12/4/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating fire drills are now scheduled and placed on the centers monthly calendar. Item #853 – The incident log was reviewed today. The incident log is in use as required. Item #858 – This was corrected during the visit on 12/4/23. Item #859 – The last monthly playground inspection was completed on 12/7/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating monthly playground inspections are now scheduled and placed on the centers monthly calendar. Items #1035 – We discussed the Emergency Information form must be on file on day one of employment. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating that a review of the orientation process was conducted, and all staff files were audited to be sure all staff had the emergency information form on file. Items #1045 and #1067 – Documentation of orientation was verified today for the one (1) staff. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating a review of the orientation process was conducted, and all staff files were audited to be sure all staff had orientation documented. Item #1048 and #1049 – CPR and First Aid training for the one (1) staff was reviewed and verified to be completed on 12/11/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Item #1052 – The three (3) staff files lacking on-going training hours were reviewed today and not verified to meet on-going training hours in accordance with their education. This is a repeat violation from 12/4/23. Item #1232 – Annual staff development plans were completed for the six (6) staff on 12/6/23. Annual staff evaluations will be completed under the new ownership annually. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Item #1867 – The depth of the surfacing on playgrounds #1, #3, and #6 has not been corrected to meet six (6) inches or more. Ms. Pace emailed a request for an extension today during the visit. Per Ms. Pace, the operator had to call around locally to find what mulch was approved to use on the playgrounds. Once the information was provided by local vendors, an order for mulch was placed on 12/15/23. Staff was notified this morning that children cannot play on the climbing structures on playgrounds #1, #3, and #6 until mulch is delivered, installed, and adequate depth. An extension has been approved through 12/22/23 at the close of business for the mulch to be delivered, installed, and of adequate depth. Item #1874 – The three (3) staff were verified to have the prevention of shaken baby and abusive head trauma policy acknowledgement on file today. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Staff child/ratio was as follows today: Space #1 was not in use by children. Space #2 was not in use by children. Space #3 had one (1) teacher and eight (8) two year through three year old children. Space #4 had one (1) teacher and nine (9) four through five year old children. Space #A had one (1) teacher and four (4) infant and one year old children. Space #B had one (1) teacher and seven (7) two year old children. Space #C was not in use by children. Space #D had two (2) teachers and seven (7) one through two year old children. There following violation of child care requirements was observed: Violation Number Comment Rule 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) of three (3) staff, S.T., required to complete ten (10) training hours and has received one (1) training hour. One (1) of three (3) staff, A.H., required to compete ten (10) training hours and has received five (5) training hours. One (1) of three (3) staff, M.F., required to complete ten (10) training hours and has receive three (3) training hours. Repeat violation from 12/4/23. .1103(a) Technical assistance for correction plan: On-going Training (repeat violation from 12/4/23) The three (3) staff must complete additional training hours from an approved agency. According to the Workforce Education Status Letter, one (1) staff meets lead teacher qualifications through the Early Childhood Certification Level 8, which requires ten (10) training hours annually. If the staff has a two year degree in early childhood education, it is recommended to send in official transcripts to WORKS for evaluation. During the visit today, it was discovered that there is training taken by staff that is not be approved. A representative from the Division of Child Development and Early Education (DCDEE) researched to find out BEE Institute is not an approved training agency through DCDEE. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Required Training Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement 15 clock hours If none of the other criteria in this chart apply 20 clock hours 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 1/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 79%. The compliance history after the visit will be reviewed to determine if the facility will be able to transition to a star-rated license or be recommended for an administrative action. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator’s non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; Consultation: We discussed that when the monthly playground inspection is completed to be sure to describe the problem and provide a solution. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/18/2023 Number Present: 35 Completed Date: 12/18/2023 Age: From 0 To 5 Total Minutes: 205 Time In: 09:20 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance for violations that were cited during a Temporary Time Period visit on 12/4/23 and provide limited monitoring of child care requirements. Tracy Pace, Administrator, was on site and available to ask and answer questions. During the Temporary Time Period visit on 12/4/23, sixteen (16) violations were cited. The children were observed during routine care, free play, small group activities, and large group activities today during the walk through. The violations documented on 12/4/23 were monitored and discussed as follows: Item #205 – This was corrected during the visit on 12/4/23. Item #714 – The gap between the building and fence on outdoor spaces #5 and #6 had a large storage chest in front of it to close the gap during the visit on 12/4/23. During observations today, additional fencing has been added to close the gap permanently. The large storage chest has now been moved away from this area. Items #721 – The plastic gate on outdoor space #4 has been removed. The metal poles on outdoor space #4 have been removed. Item #805 – A fire drill was practiced during the visit on 12/4/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating fire drills are now scheduled and placed on the centers monthly calendar. Item #853 – The incident log was reviewed today. The incident log is in use as required. Item #858 – This was corrected during the visit on 12/4/23. Item #859 – The last monthly playground inspection was completed on 12/7/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating monthly playground inspections are now scheduled and placed on the centers monthly calendar. Items #1035 – We discussed the Emergency Information form must be on file on day one of employment. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating that a review of the orientation process was conducted, and all staff files were audited to be sure all staff had the emergency information form on file. Items #1045 and #1067 – Documentation of orientation was verified today for the one (1) staff. A letter of compliance with a statement regarding this violation was received today, 12/18/23, stating a review of the orientation process was conducted, and all staff files were audited to be sure all staff had orientation documented. Item #1048 and #1049 – CPR and First Aid training for the one (1) staff was reviewed and verified to be completed on 12/11/23. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Item #1052 – The three (3) staff files lacking on-going training hours were reviewed today and not verified to meet on-going training hours in accordance with their education. This is a repeat violation from 12/4/23. Item #1232 – Annual staff development plans were completed for the six (6) staff on 12/6/23. Annual staff evaluations will be completed under the new ownership annually. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Item #1867 – The depth of the surfacing on playgrounds #1, #3, and #6 has not been corrected to meet six (6) inches or more. Ms. Pace emailed a request for an extension today during the visit. Per Ms. Pace, the operator had to call around locally to find what mulch was approved to use on the playgrounds. Once the information was provided by local vendors, an order for mulch was placed on 12/15/23. Staff was notified this morning that children cannot play on the climbing structures on playgrounds #1, #3, and #6 until mulch is delivered, installed, and adequate depth. An extension has been approved through 12/22/23 at the close of business for the mulch to be delivered, installed, and of adequate depth. Item #1874 – The three (3) staff were verified to have the prevention of shaken baby and abusive head trauma policy acknowledgement on file today. A letter of compliance with a statement regarding this violation was received today, 12/18/23. Staff child/ratio was as follows today: Space #1 was not in use by children. Space #2 was not in use by children. Space #3 had one (1) teacher and eight (8) two year through three year old children. Space #4 had one (1) teacher and nine (9) four through five year old children. Space #A had one (1) teacher and four (4) infant and one year old children. Space #B had one (1) teacher and seven (7) two year old children. Space #C was not in use by children. Space #D had two (2) teachers and seven (7) one through two year old children. There following violation of child care requirements was observed: Violation Number Comment Rule 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One (1) of three (3) staff, S.T., required to complete ten (10) training hours and has received one (1) training hour. One (1) of three (3) staff, A.H., required to compete ten (10) training hours and has received five (5) training hours. One (1) of three (3) staff, M.F., required to complete ten (10) training hours and has receive three (3) training hours. Repeat violation from 12/4/23. .1103(a) Technical assistance for correction plan: On-going Training (repeat violation from 12/4/23) The three (3) staff must complete additional training hours from an approved agency. According to the Workforce Education Status Letter, one (1) staff meets lead teacher qualifications through the Early Childhood Certification Level 8, which requires ten (10) training hours annually. If the staff has a two year degree in early childhood education, it is recommended to send in official transcripts to WORKS for evaluation. During the visit today, it was discovered that there is training taken by staff that is not be approved. A representative from the Division of Child Development and Early Education (DCDEE) researched to find out BEE Institute is not an approved training agency through DCDEE. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually, as follows: Education and Experience Required Training Four-year degree or higher advanced degree in a child care related field of study from a regionally accredited college or university 5 clock hours Two-year degree in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Administration Credential 8 clock hours Certificate or diploma in a child care related field of study from a regionally accredited college or university, or persons with a North Carolina Early Childhood Credential 10 clock hours 10 years documented experience as a teacher, director, or caregiver in a licensed child care arrangement 15 clock hours If none of the other criteria in this chart apply 20 clock hours 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 1/1/24. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive 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 within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. The compliance history for the facility prior to the visit today was 79%. The compliance history after the visit will be reviewed to determine if the facility will be able to transition to a star-rated license or be recommended for an administrative action. 10A NCAC 09 .2215 DENIAL OF A LICENSE (a) The Secretary may deny an application for a child care facility license or the issuance of any permit to operate a child care facility under the following circumstances: (8) based on the operator’s non-compliance with the requirements of G.S. 110, Article 7, 10A NCAC 10, or this Chapter, during a temporary licensure period; Consultation: We discussed that when the monthly playground inspection is completed to be sure to describe the problem and provide a solution. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or 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 .0302 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0508 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0802 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1101 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-105 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: KID CITY USA PISGAH FOREST Facility ID: 88000110 Consultant: MONICA HOUCK Operation Type: Center Case Number: Visit Date: 12/4/2023 Number Present: 37 Completed Date: 12/4/2023 Age: From 0 To 5 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time period visit. This facility is on a temporary license due to a change of ownership. Tracy Pace, Administrator, was on-site and available to answer and ask questions. Kaylee D’Arcy, Director of Quality and Compliance, arrived at approximately 10:15am. Dawn McCrary, Child Care Consultant, arrived at approximately 10:00am to assist with monitoring staff and child files. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Monica Houck, Lead Child Care Consultant and signed by Tracy Pace, during the visit. An electronic signed copy of the visit summary was electronically emailed to Jenny Mounivong, Legal Operator. Currently this center operates with a Temporary License, issued 10/30/23 and is effective through 4/30/24. The restrictions include daytime care only; meets enhanced space; meets enhanced ratios; maximum capacity seventy-four (74) children; maximum of twelve staff due to septic system restriction; and age range; 0-5 years. The Secretary of State website was reviewed today, and the company, The Forest Hive, Inc., is listed as active-current. If any changes to the organization need to be made or you decide to sell your business, then you must notify your consultant at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location or inherited. During this first Temporary Time Period visit, classrooms were monitored as well as the playground, materials, equipment and required posted items for meeting all minimum licensing requirements. The last monthly fire drill was practiced today, 12/4/23. There was no documentation of a fire drill being practiced in October 2023 or November 2023. A shelter-in-place drill or lockdown drill will need to be practiced on or before 1/30/23. There is no documentation of the monthly playground inspection being completed for October 2023, November 2023, or December 2023. A sanitation inspection must be completed during the temporary time period. An approved fire inspection must completed during the temporary time period. An approved building inspection must be completed during the temporary time period. A zoning letter for the facility must be provided during the temporary time period. Administrative, operational, and personnel policies must meet all required topics. Operational and personnel policies have been submitted and reviewed. Clarifications or revisions are needed. The administrative policies must be submitted for review. The administrative, operational, and administrative policies must meet all required topics prior to the expiration of the temporary license. The Emergency Preparedness Response (EPR) plan must be completed on or before 2/29/24. Ms. Pace completed EPR training on 5/16/18. The emergency medical care (EMC) plan was posted. The incident log was not in use. The children were observed during routine care, free play, outdoor play, lunch, and rest time. All children bring their meals and snacks. A nutrition opt-out form must be on file for each child. Three (3) children files were monitored. There are twelve (12) staff. Twelve (12) staff files were monitored. To continue to serve children on subsidy vouchers, the facility must transition to a three-star license or higher. If the facility cannot achieve a three-star license or higher, no children can be served that receive subsidy vouchers. Due to the ownership change, the facility has the option to use the previous ownership’s five-star rating and be included in the rated license cycle for the previous facility, Cohort 1. It is recommended to request a prep year assessment for the facility while on a temporary license. The Initial Application for Assessment for a Two Component Star Rated License can be found on the Division’s website if you would like to apply for a rated license and the Rated License Request for Review Form can be requested if you would like to request the Environment Rating Scale (ERS) assessment. Plan to visit the ncrlap.org website to learn more about the assessment process. You may also request an Outreach Assessment through the North Carolina Rated License Assessment Project (NCRLAP). I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations of child care requirements were observed today: Violation Number Comment Rule 205 Storage space was not available for each child's personal belongings. Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. G.S. 110-91(6) 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. .0605(g) 721 All equipment and furnishings were not in good repair. The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. G.S. 110-91(6); .0601(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. There was no documentation of a fire drill being practiced in October 2023 or November 2023. .0604(t); .0302(d)(5) 853 Incident logs were not completed and maintained as required. An incident log is not in use. .0802(g)(1-6) 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. Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. .0605(q) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current First Aid training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff, per the staff and training worksheet, does not have current CPR training. .1102(d) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Three (3) staff, per the staff and training worksheet, which are required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. .1103(a) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514(f) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. .0605(k)(1-4) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. .0608(d)(1-4) Technical assistance for correction plan: Item 853 - An incident log is not in use. *Incident Logs All incident reports must be logged as required in rule below. We discussed that you have the incident log and will begin logging any incident reports. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (g) An incident log shall be completed any time an incident report is completed. This log shall: (1) include the name of the child; (2) include the date of the incident; (3) include the date the incident report was submitted to the Division, if applicable; (4) include the name of the staff member who complete the incident report; (5) be cumulative and maintained in a separate file; and (6) be available for review by a representative of the Division. This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website. Item 805 - There was no documentation of a fire drill being practiced in October 2023 or November 2023. *Monthly Fire Drills A plan must be put in place to be sure a fire drill is practiced monthly as required. We discussed placing the drill on the calendar monthly. A fire drill was requested to be practiced today. We also discussed that the fire alarm pull station will need to be pulled to practice future fire drills. The children were alerted through the fire alarm test system in one building and verbally in another building. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (t) Fire drills shall be practiced monthly and records shall be maintained as required by 10A NCAC 09 .0302(d)(5). Item 858 – Easily torn plastic was located accessible to children under three years of age in unlocked cubbies below five feet in space #B. *Easily Torn Plastics – Corrected During the Visit The plastic bag and other easily torn plastics were placed above at five feet from the floor during the visit. 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. Item 0205 – – Storage space for children’s personal belongings was not provided in spaces #3 and #4. The children’s coats, backpacks, and other personal belongings were laying on the floor in the hallway. *Storage for Children’s Personal Belongings - Corrected During the Visit There must be space children’s personal belongings for space #3 and #4. We discussed using temporary plastic hooks while waiting on the cubbies to be completed. The plastic hooks have been placed on the wall and the children’s belongings are now off the floor and hanging. § 110-91. Mandatory standards for a license. (6)… Space shall be available for proper storage of beds, cribs, mats, cots, sleeping garments, and linens as well as designated space for each child's personal belongings… Item #1867 - The surfacing for the equipment on outdoor spaces #1, #3, and #6 had mulch surfacing with depths between one (1) inch and three (3) inches. *Depth of Surfacing The majority of the mulch has deteriorated and must be replenished, on outdoor spaces #1, #3, and #6, to at minimum six (6) inches based on the critical height of the equipment. We discussed you do have a contact for a supplier for mulch. However, it may take time to get the mulch at the facility. Plan to go ahead and order the mulch and have a back-up plan of keeping children off the structures until compliance can be achieved. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; Item #721 - The plastic gate on outdoor space #4 has detached from the metal poles in at least three (3) different places. The metal poles are sticking up approximately two (2) feet from the ground and the plastic gates has fallen to the ground in various places. * Outdoor Equipment in Poor Repair The plastic gate must either be reattached to the metal poles or the metal poles and the plastic gate must be removed from outdoor space #4. We discussed to check with Transylvania Environmental Health to find out if the green indoor/outdoor carpeting on outdoor space #4 is approved for long-term use outdoors due to the possibility of mold and mildew. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Item #428 – The activity plan in space #A, the classroom with infants, was dated June 2023. *Activity Plans – Corrected During the Visit The activity plan for space #A must be current. An activity plan for the week of 12/4/23 was printed and posted during the visit. 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. Item 859 – There was no documentation that monthly playground inspections were conducted in October 2023 or November 2023. *Monthly Playground Inspections A plan must be put in place to state how playground inspections will be completed on a monthly basis as required. We discussed using a calendar to keep track of the requirement. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Item 714 – There was a five (5) to eight (8) inch gap between the building and fence on outdoor spaces #5 and #6. Outdoor Safety – Corrected During the Visit *The gap between the building and the fence must be closed to less than 3.5 inches. A large storage chest was placed in front of the gap to correct during the visit. We also discussed that lattice will be placed over the gap in the near future. 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. 1045- One (1) staff, per the staff and training worksheet, did not receive at least 16 hours of orientation within first 6 weeks. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Firsthand observation of the center's daily operations Instruction in the employee's assigned duties Instruction in the maintenance of a safe and healthy environment Instruction in the administration of medication to children in accordance with 10A NCAC 09 .0803 Review of the center's purposes and goals Review of the child care licensing law and rules Review of Section .2800 of this Chapter if the center has a two- through five- star license at the time of employment An explanation of the role of State and local government agencies in the regulation of child care, their impact on the operation of the center, and their availability as a resource An explanation of the employee's obligation to cooperate with representatives of State and local government agencies during visits and investigations Prevention of and response to emergencies due to food and allergic reactions Review of the center's handling and storage of hazardous materials and the appropriate disposal of biocontaminants. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1067- Two (2) staff, per the staff and training worksheet, did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (b) New staff orientation shall include an overview of the following topics, focusing on the operation of the center: Information regarding recognizing, responding to, and reporting child abuse, neglect, or maltreatment pursuant to G.S. 110-105.4 and G.S. 7B-301 Review of the center's operational policies, including the center's safe sleep policy for infants, the center's policy for transportation, the center's identification of building and premises safety issues, the Emergency Preparedness and Response Plan, and the emergency medical care plan. Adequate supervision of children in accordance with 10A NCAC 09 .1801 Information regarding prevention of shaken baby syndrome and abusive head trauma and child maltreatment Prevention and control of infectious diseases, including immunization. Plan to use a calendar to ensure the required orientation hours are completed and documented as required. 1232- Six (6) staff, per the staff and training worksheet, do not have a current annual staff evaluation or current professional development plan on file. One (1) staff does not have a current annual staff evaluation on file. 10A NCAC 09 .0514 OPERATIONAL AND PERSONNEL POLICIES (f) In addition to all records required in Rule .0302(d) of this Chapter, each employee's personnel file shall contain an annual staff evaluation and staff development plan. Annual staff evaluations and Professional development plans are scheduled to be completed in the near future. 1035- One (1) staff, per the staff and training worksheet, did not have the required Emergency Information Form on file on or before the first day of work. Item: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. Due Date: On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Plan to have all newly hired staff complete the Emergency Information Form on their first day of work and file in their personnel file. 1052- Three (3) staff required to receive on-going training, did not have documentation of completion of the required number of hours according to their education and experience. 10A NCAC 09 .1103 ON-GOING TRAINING AND PROFESSIONAL DEVELOPMENT (a) After the first year of employment, the child care administrator and any staff who have responsibility for planning and supervising a child care center, and staff who work with children, shall participate in on-going training activities annually. On-going training documentation was not on file due to the ownership change and retention of documents. Plan to maintain this documentation as required. #1048 & #1049- One (1) staff, per the staff and training worksheet, does not have current CPR and FA training. We discussed to sign the staff up immediately for the training. Plan to contact me if you need assistance finding a training within the next two weeks. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. 1874- Three (3) staff, per the staff and training worksheet, did not have a signed acknowledgement of The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy being reviewed with them prior to providing care with children. 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) Within 30 days of adopting the policy, the child care center shall review the policy with existing staff members who provide care for children up to five years of age. Each child care center shall review the policy with new staff members prior to the individual providing care to children. The acknowledgement of this review shall contain: (1) the individual’s name; (2) the date the center’s policy was given and explained to the individual; (3) the individual’s signature; and (4) the date the individual signed the acknowledgment. The child care center shall retain the acknowledgement in the staff member’s file. A plan is in place to schedule CPR and FA for the staff with expired trainings and newly hired staff in need of the trainings. 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 could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement on or before 12/18/23. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: monica.houck@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education (DCDEE) Attn: Monica Houck PO Box 880, Fletcher, NC 28732 Please call me at 828-243-2154, or email monica.houck@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Rated License Assessment: Compliance History: The program must maintain a 75% or higher compliance history score to be eligible for a 2-5 star rated license. Staff Education: It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submitted an official transcript (if applicable) and applied 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. *Note - The facility may choose to use staff education points from the previous ownership. Program Standards: The Initial Application for a Two Component Star Rated License can be found on the Division’s website and the Rated License Request for Review form can be requested if you choose to apply for a two through five-star rated license and have the (ERS) assessment. *Note - The facility may choose to use program standard points from the previous ownership. Quality Point: A quality point has not been determined. *Note - The facility may choose to use the quality point from the previous ownership. Curriculum: All four and five star rated license facilities must implement an approved curriculum with four year-old children. The curriculum being implemented is Creative Curriculum. The curriculum book was not available for review today and will be reviewed during the next visit. Rated License Consultation: ITERS-R and ECERS-R A variety of different types of blocks such as wooden unit blocks, soft unit blocks, cardboard blocks, and homemade blocks with enough blocks in each set for at least three children to build a structure should be provided. The block center should be large enough for three children to build a substantial structure without interfering with one each other’s play. Art projects should allow individual expression by children. Copied, cookie cutter type art projects do not offer children an opportunity for individual expression. Allow children to choose the art media of their choice and provide a variety of materials. The following are suggestions for art materials: markers, chalk, colored pencils, paper, crayons, dry erase markers, finger paint, tape, glue, stickers, small pieces of paper, play dough, clay, hole punchers, stencils, stamps, and scissors. Children under three years age should not have access to materials that would be considered choking hazards such as foam items, small crayons, small pieces of chalk, plastic bags, items easily torn apart or that would fit in a choking tube. You can use these materials under direct teacher supervision working one on one with the child during the art activity. Display in the classroom should be primarily children’s work and not teacher or store-bought display. Children’s art should be posted on their eye level. Avoid long periods of waiting during transitions such as bathroom time or from one activity to another. Develop ideas and strategies to reduce waiting time for children. Teachers can sing songs and do finger plays with the children who are waiting. If children wait more than three minutes without activity, then you will be marked down on the ERS assessment score. Items such as puzzles and games that are missing pieces should be removed from the classroom and replaced. The classroom should have at least two books per child that are age appropriate for the children in the group. A variety of books that portray real animal pictures, families, disabilities and different cultures should be added to each classroom. Remove any books that are worn, torn or missing pages. Add pictures, books, puzzles, block play people, baby dolls, music, play food and dress-up clothes that represent different cultures. Add pictures, puzzles and block play people that represent people of all ages and disabilities. Water must be available to children throughout the day. Have a pitcher of water and cups for children available at all times. Tables must be cleaned with soapy water then wiped dry. Then spray table with the sanitizing solution and let it sit for at least two minutes before wiping dry. Follow this procedure before and after eating. Make sure no children are near the table when spraying the sanitizing solution. Sinks must be disinfected between changes of use. The staff should spray the sink with the disinfectant spray and allow the disinfectant to stay for at least two minutes before turning on the water and using the sink. All children must have their diapers or pull ups checked or changed at least every two hours and when soiled. Use a timer or follow a daily individual diaper changing schedule to keep you within the two-hour timeframe. Children must wash their hands upon arrival, before and after eating, before and after sand and water play, after toileting, after outdoor play, after handling messy art materials such as paint, glue, and playdough and after touching nose, mouth, floor, trashcan, and anything else that re-contaminates the hands. Staff should follow proper handwashing procedures and wash hands as required. Remove mouthed items from play immediately and sanitize before allowing other children to play with item. You must interact with children in relation to their play with materials. At least two instances must be observed. Math/number - One instance must be observed during routine care as well as during free play of using math/number. It is recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessments. Additional notes to the Early Childhood Environment Rating Scale Revised Edition can be obtained on this website. NCRLAP also offers the Outreach Assessment and Webinar trainings for staff. I also recommended that you register staff now for the upcoming Webinar trainings listed on the ncrlap.org website. Contact your local Child Care Resource and Referral office for further technical assistance with the Environment Rating Scales. Child Care Resource and Referral (CCR&R) Agency – The Children and Family Resource Center – Heather Erwin, heathere@childrenandfamily.org, Office: 828.698.0674, ext. 154 Consultation: Because of the number of violations a follow-up visit may be conducted soon. We discussed the storage for the children’s personal belongings in spaces #3 and #4 must following sanitation requirements as well. 15A NCAC 18A .2820 STORAGE (f) Individual cubicles, lockers, or coat hooks shall be provided for storage of coats, hats, bags, or other items and accessories. Coat hooks not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children…. It was discovered that outdoor space #7 and outdoor space #6 had a fenced removed prior to the change of ownership. The space will now be referred to as space #6 and the capacity is 36 children at 100 square feet per child. If any changes need to be made to indoor or outdoor spaces in the future, plan to contact the child care consultant with a thirty (30) day notice. Ms. Mounivong requested the facility phone number be changed from 828-577-9950 to 828-877-2555. This change has been keyed in the Regulatory system. The rated license dated 10/10/23, from the previous ownership was collected today and will be returned to DCDEE in Raleigh. We discussed there is a child with an epi-pen that must be discarded by 12/27/23 based on the prescription label in space #B. Plan to request a new epi-pen from the parent. We discussed that as the administrator, you only have two (2) months to complete ITS-SIDS training, due on 12/30/23. Continue to keep the staff and training worksheet updated as changes occur. Anytime staff changes occur, plan to update the Emergency Medical Care (EMC) plan to reflect the changes. We discussed the EMC plan needs to be updated. The EMC plan must be updated at least annually if no changes during the year and posted to be easily viewed. Reminder that immunization and children’s medical reports are due within 30 days of enrollment. 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 the child care consultant within thirty (30) days prior to the change. Failure to notify the child care consultant, may result in a violation of child care requirements. Compliance History Score Any observed violations cited during visits will negatively affect the center's Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c). Health and Safety Training 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 as needed. The North Carolina Early Childhood Equivalency Exam is now available on DCDEE Moodle. Visit the Division’s website to find out more information. Please continue to visit DCDEE’s website to get the latest information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at monica.houck@dhhs.nc.gov or 828.243.2154, or my supervisor, Bonnie Mathis at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times