10A NCAC 09 .0701 · Violation

Name of Operation: SAFE HAVEN PRESCHOOL AND CHILDCARE CENTER Facility ID: 92003625 Consultant: ANTIONETTE WILLIAMS Operation Type: Center Case Number: Visit Date: 5/23/2025 Number Present: 8 Completed Date: 5/23/2025 Age: From 3 To 5 Total Minutes: 100 Time In: 09:15 AM Time Out: 10:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today's announced visit was to monitor compliance with child care requirements for a rated license assessment. The last annual compliance visit was conducted on 9/18/2024. You, Betty King, Center Director, assisted me today. Your program currently operates with a Five-Star license. Children were participating in free play including, completing art activities, building with blocks, playing with play dough, and completing floor puzzles. Supervision, group size, permit capacity, staff/child ratios and space capacity complied. There was one new staff member. Staff’s qualifying letter and special training complied. Staff’s CPR and first aid certifications were current. Children’s records were not monitored. One violation related to staff records was cited. Program records complied. Fire and sanitation inspections were current. The emergency medical care plan was accessible. ADDITIONAL REQUIREMENTS: General health requirements complied. You explained there are no medications at the facility. The facility continues to meet requirements for adequate and approved space. The facility’s owner is active/current with the NCSOS. The environment rating scale summaries and items scoring less than a three were reviewed today with you, Brandi Nobles, Center Director. These items are documented below. ECERS-R (4/25/2024) – 5.67score K. Hardy; F. Penn; B. King Item 3 – indicator 3.2 You explained you have pillows and have added some soft items since the assessment. Item 7 – indicator 3.2 You explained you have the maintenance to adjust the portable equipment from time to time. The children will push on and move the equipment. You further explained you also measure the distance. Item 13 – indicator 3.1 You explained, you and staff wash your hands constantly. You explained handwashing is not a concern. Item 14 – indicator 3.1 The same information for item 7 applies. Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One staff member employed in April 2025 does not have a medical report on file. 10A NCAC 09 .0701(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before 6/5/2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Antionette Williams 2201 Mail Service Center Raleigh, NC 27699 Antionette.williams@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 TECHNICAL ASSISTANCE: Staff medical statement are required to be on file the first day of employment. This ensures staff have been assessed by a medical professional and are able to work in child care. You explained the staff member is waiting for the statement from their medical professional. Rated License Re-Assessment: Program Standards: 6 points The facility as operational and personnel policies that have been approved. The facility received a score of 5.67 on the ECERS-R. The facility meets the requirements of enhanced space and enhanced ratios. Education Standards: 6 points The following points in education were achieved for each position as follows: Administrator – 7 points Lead Teacher – 7 points Teacher - 6 points Quality Point: 1 point The facility meets the requirement of the administrator, has at least 10 years of documented early childhood work experience that can be verified by the Division. The facility uses the Lillio Learning for Preschool Curriculum. The compliance history is 98 percent. The facility has earned 13 out of 15 points. A Five Star License will be issued once all violations are corrected. Feel free to contact me with questions at 919-819-9383 or antionette.williams@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.

NC GS 110-90 · Violation

Name of Operation: SAFE HAVEN PRESCHOOL AND CHILDCARE CENTER Facility ID: 92003625 Consultant: ANTIONETTE WILLIAMS Operation Type: Center Case Number: Visit Date: 5/23/2025 Number Present: 8 Completed Date: 5/23/2025 Age: From 3 To 5 Total Minutes: 100 Time In: 09:15 AM Time Out: 10:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Rated License Assessment Announced/Unannounced: Announced The purpose of today's announced visit was to monitor compliance with child care requirements for a rated license assessment. The last annual compliance visit was conducted on 9/18/2024. You, Betty King, Center Director, assisted me today. Your program currently operates with a Five-Star license. Children were participating in free play including, completing art activities, building with blocks, playing with play dough, and completing floor puzzles. Supervision, group size, permit capacity, staff/child ratios and space capacity complied. There was one new staff member. Staff’s qualifying letter and special training complied. Staff’s CPR and first aid certifications were current. Children’s records were not monitored. One violation related to staff records was cited. Program records complied. Fire and sanitation inspections were current. The emergency medical care plan was accessible. ADDITIONAL REQUIREMENTS: General health requirements complied. You explained there are no medications at the facility. The facility continues to meet requirements for adequate and approved space. The facility’s owner is active/current with the NCSOS. The environment rating scale summaries and items scoring less than a three were reviewed today with you, Brandi Nobles, Center Director. These items are documented below. ECERS-R (4/25/2024) – 5.67score K. Hardy; F. Penn; B. King Item 3 – indicator 3.2 You explained you have pillows and have added some soft items since the assessment. Item 7 – indicator 3.2 You explained you have the maintenance to adjust the portable equipment from time to time. The children will push on and move the equipment. You further explained you also measure the distance. Item 13 – indicator 3.1 You explained, you and staff wash your hands constantly. You explained handwashing is not a concern. Item 14 – indicator 3.1 The same information for item 7 applies. Violation Number Comment Rule 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. One staff member employed in April 2025 does not have a medical report on file. 10A NCAC 09 .0701(a) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before 6/5/2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Antionette Williams 2201 Mail Service Center Raleigh, NC 27699 Antionette.williams@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 TECHNICAL ASSISTANCE: Staff medical statement are required to be on file the first day of employment. This ensures staff have been assessed by a medical professional and are able to work in child care. You explained the staff member is waiting for the statement from their medical professional. Rated License Re-Assessment: Program Standards: 6 points The facility as operational and personnel policies that have been approved. The facility received a score of 5.67 on the ECERS-R. The facility meets the requirements of enhanced space and enhanced ratios. Education Standards: 6 points The following points in education were achieved for each position as follows: Administrator – 7 points Lead Teacher – 7 points Teacher - 6 points Quality Point: 1 point The facility meets the requirement of the administrator, has at least 10 years of documented early childhood work experience that can be verified by the Division. The facility uses the Lillio Learning for Preschool Curriculum. The compliance history is 98 percent. The facility has earned 13 out of 15 points. A Five Star License will be issued once all violations are corrected. Feel free to contact me with questions at 919-819-9383 or antionette.williams@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: SAFE HAVEN PRESCHOOL AND CHILDCARE CENTER Facility ID: 92003625 Consultant: ANTIONETTE WILLIAMS Operation Type: Center Case Number: Visit Date: 9/18/2024 Number Present: 8 Completed Date: 9/18/2024 Age: From 3 To 4 Total Minutes: 60 Time In: 01:15 PM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. A full assessment of child care requirements was conducted. Your program currently operates with a Five-star license. The facility was monitored for approved curriculum. Today’s visit was conducted with you, Betty King, Center Director. You visited the child care area with me. I monitored the classroom for compliance with staff/child ratios, supervision, capacity, group size and staff interaction/discipline. Children throughout the facility were resting. The staff provided supervision for children. The facility was monitored for health and safety requirements indoors and outdoors. Program requirements, along with equipment and furnishings were monitored. One violation regarding program records was documented. All inspections and drills were current. A sampling of children’s and existing staff’s records was monitored and information documented on the children’s records form and the staff and training worksheet. Two violations regarding children’s records were documented. A checklist was also used to monitor compliance. I monitored one vehicle passenger van used for field trips. The information was documented on the checklist. The last annual compliance visit was conducted 11/15/2023. Prior to today’s visit, the facility’s compliance history was 100 percent. The owner/operator is listed as Active-Current with the NC Secretary of State. Violation Number Comment Rule 1303 Application was not signed by the parent. The application was not signed by the parent for two children. 10A NCAC 09 .0801(a) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Immunization record was not on file for two children. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was last reviewed on 7/26/2023. .0607(e) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before 10/2/2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Antionette Williams PO Box 312 Garner, NC 27529 Antionette.williams@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 TECHNICAL ASSISTANCE: Today we reviewed the required components for a child’s application. You worked with an agency to recreate required forms including the child’s application. I reviewed with you the children records form and how it corresponds to parts of the application including the requirement for the parent signature. There were other forms that had parent signatures and/or initials. You inquired about forms that were due annually and other items that must be renewed. I encouraged you to visit MOODLE on DCDEE website and complete the child care requirement overview training as a refresher. I also encouraged you to use a children’s record and staff’s records checklist. You stated you will correct the missing signature. Lead Free Classrooms: It appears you have completed the lead-free water and lead in paint testing. The asbestos testing notes, a survey review by RTI. Hold harmless - Hold harmless has been extended until the new QRIS is implemented (SB 425). This means that you do not need to complete the rated license process unless you voluntarily request to. Providers in Cohort 1 are not required to go any further with a rated license assessment unless you want to, and providers in Cohort 2 do not need to start their preparation year unless you want to. You completed the ERS on 9/5/2024. You needed to leave today so we discussed scheduling another time to review the results of the ECERS-R. The violations were reviewed with you today. The visit summary was not left with you but emailed after the visit. You needed to leave the facility and were planning to return later. Feel free to contact me with questions at 919-819-9383 or antionette.williams@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 .0801 · Violation

Name of Operation: SAFE HAVEN PRESCHOOL AND CHILDCARE CENTER Facility ID: 92003625 Consultant: ANTIONETTE WILLIAMS Operation Type: Center Case Number: Visit Date: 9/18/2024 Number Present: 8 Completed Date: 9/18/2024 Age: From 3 To 4 Total Minutes: 60 Time In: 01:15 PM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. A full assessment of child care requirements was conducted. Your program currently operates with a Five-star license. The facility was monitored for approved curriculum. Today’s visit was conducted with you, Betty King, Center Director. You visited the child care area with me. I monitored the classroom for compliance with staff/child ratios, supervision, capacity, group size and staff interaction/discipline. Children throughout the facility were resting. The staff provided supervision for children. The facility was monitored for health and safety requirements indoors and outdoors. Program requirements, along with equipment and furnishings were monitored. One violation regarding program records was documented. All inspections and drills were current. A sampling of children’s and existing staff’s records was monitored and information documented on the children’s records form and the staff and training worksheet. Two violations regarding children’s records were documented. A checklist was also used to monitor compliance. I monitored one vehicle passenger van used for field trips. The information was documented on the checklist. The last annual compliance visit was conducted 11/15/2023. Prior to today’s visit, the facility’s compliance history was 100 percent. The owner/operator is listed as Active-Current with the NC Secretary of State. Violation Number Comment Rule 1303 Application was not signed by the parent. The application was not signed by the parent for two children. 10A NCAC 09 .0801(a) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Immunization record was not on file for two children. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was last reviewed on 7/26/2023. .0607(e) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before 10/2/2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Antionette Williams PO Box 312 Garner, NC 27529 Antionette.williams@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 TECHNICAL ASSISTANCE: Today we reviewed the required components for a child’s application. You worked with an agency to recreate required forms including the child’s application. I reviewed with you the children records form and how it corresponds to parts of the application including the requirement for the parent signature. There were other forms that had parent signatures and/or initials. You inquired about forms that were due annually and other items that must be renewed. I encouraged you to visit MOODLE on DCDEE website and complete the child care requirement overview training as a refresher. I also encouraged you to use a children’s record and staff’s records checklist. You stated you will correct the missing signature. Lead Free Classrooms: It appears you have completed the lead-free water and lead in paint testing. The asbestos testing notes, a survey review by RTI. Hold harmless - Hold harmless has been extended until the new QRIS is implemented (SB 425). This means that you do not need to complete the rated license process unless you voluntarily request to. Providers in Cohort 1 are not required to go any further with a rated license assessment unless you want to, and providers in Cohort 2 do not need to start their preparation year unless you want to. You completed the ERS on 9/5/2024. You needed to leave today so we discussed scheduling another time to review the results of the ECERS-R. The violations were reviewed with you today. The visit summary was not left with you but emailed after the visit. You needed to leave the facility and were planning to return later. Feel free to contact me with questions at 919-819-9383 or antionette.williams@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: SAFE HAVEN PRESCHOOL AND CHILDCARE CENTER Facility ID: 92003625 Consultant: ANTIONETTE WILLIAMS Operation Type: Center Case Number: Visit Date: 9/18/2024 Number Present: 8 Completed Date: 9/18/2024 Age: From 3 To 4 Total Minutes: 60 Time In: 01:15 PM Time Out: 02:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. A full assessment of child care requirements was conducted. Your program currently operates with a Five-star license. The facility was monitored for approved curriculum. Today’s visit was conducted with you, Betty King, Center Director. You visited the child care area with me. I monitored the classroom for compliance with staff/child ratios, supervision, capacity, group size and staff interaction/discipline. Children throughout the facility were resting. The staff provided supervision for children. The facility was monitored for health and safety requirements indoors and outdoors. Program requirements, along with equipment and furnishings were monitored. One violation regarding program records was documented. All inspections and drills were current. A sampling of children’s and existing staff’s records was monitored and information documented on the children’s records form and the staff and training worksheet. Two violations regarding children’s records were documented. A checklist was also used to monitor compliance. I monitored one vehicle passenger van used for field trips. The information was documented on the checklist. The last annual compliance visit was conducted 11/15/2023. Prior to today’s visit, the facility’s compliance history was 100 percent. The owner/operator is listed as Active-Current with the NC Secretary of State. Violation Number Comment Rule 1303 Application was not signed by the parent. The application was not signed by the parent for two children. 10A NCAC 09 .0801(a) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Immunization record was not on file for two children. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was last reviewed on 7/26/2023. .0607(e) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before 10/2/2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Antionette Williams PO Box 312 Garner, NC 27529 Antionette.williams@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 TECHNICAL ASSISTANCE: Today we reviewed the required components for a child’s application. You worked with an agency to recreate required forms including the child’s application. I reviewed with you the children records form and how it corresponds to parts of the application including the requirement for the parent signature. There were other forms that had parent signatures and/or initials. You inquired about forms that were due annually and other items that must be renewed. I encouraged you to visit MOODLE on DCDEE website and complete the child care requirement overview training as a refresher. I also encouraged you to use a children’s record and staff’s records checklist. You stated you will correct the missing signature. Lead Free Classrooms: It appears you have completed the lead-free water and lead in paint testing. The asbestos testing notes, a survey review by RTI. Hold harmless - Hold harmless has been extended until the new QRIS is implemented (SB 425). This means that you do not need to complete the rated license process unless you voluntarily request to. Providers in Cohort 1 are not required to go any further with a rated license assessment unless you want to, and providers in Cohort 2 do not need to start their preparation year unless you want to. You completed the ERS on 9/5/2024. You needed to leave today so we discussed scheduling another time to review the results of the ECERS-R. The violations were reviewed with you today. The visit summary was not left with you but emailed after the visit. You needed to leave the facility and were planning to return later. Feel free to contact me with questions at 919-819-9383 or antionette.williams@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